Contingencies Fund 2003–2004

Ordered,
	That there be laid before this House Accounts of the Contingencies Fund, 2003–2004, showing—
	(1)   the receipts and payments in connection with the Fund in the year ended 31st March 2004,
	(2)   the Distribution of the capital of the Fund at the commencement and close of the year; together with the Report of the Comptroller and Auditor General thereon.—[Joan Ryan.]

Oral Answers to Questions

HEALTH

The Secretary of State was asked—

Dentistry

Anthony D Wright: What steps are being taken to increase the number of dentists in areas of deprivation.

Rosie Winterton: We are radically reforming national health service dentistry, with £368 million of extra investment from April. We have also allocated another £59 million to help primary care trusts with the most severe access problems and we are recruiting the equivalent of 1,000 additional dentists by October 2005.

Anthony D Wright: I thank my hon. Friend for that response. The closure of one of the dental schools under the previous Administration created this long-term problem. However, we have a positive message to send from my Great Yarmouth constituency, where one of the dentists, John G. Plummer, has recruited 14 new dentists, but is still awaiting approval from the Department of Health for the issue of a new contract under the personal dental services system. Can my hon. Friend tell us when we may expect a favourable reply on that submission?

Rosie Winterton: I absolutely agree with my hon. Friend: it was in fact the closure of two dental schools that led to some of the shortages in dentistry, and that is why we announced earlier this year that we would be training another 170 dentists a year from April next year.
	On my hon. Friend's point about his constituency, I understand from discussions with him that the application has been approved in principle and that some final details are awaited. I hope those will follow before the end of the week. I am pleased that dentists in his constituency are showing enthusiasm for the new system, which is of course backed up by about £74,000 allocated from central Government to assist in dealing with access problems, which means that about another 22,000 patient registrations will become available in his constituency.

Paul Beresford: It is fairly well known that I have an interest in this matter. I assume that the Minister agrees with many of us on both sides of the House that the best improvement for dental health in deprived areas would be fluoridation. Given that assumption, can she tell me, at the second time of asking, when the long-awaited appropriate regulations will land on the desk of the House?

Rosie Winterton: I certainly agree with the hon. Gentleman about the benefits of fluoridation. The regulations are in draft and they will be published soon.

Joan Walley: The real way forward for improving the amount of dentistry in areas of deprivation is to have more training places for dentists. Will my hon. Friend note that consultation on a new dental school in Coventry and Stoke-on-Trent has just finished? Will she give me an assurance that she will look carefully at representations from north Staffordshire and give some indication that there will be ministerial approval for a school of dentistry, as a satellite in Stoke-on-Trent?

Rosie Winterton: I agree that where undergraduates train is important, as they often congregate in their own area. Through a working group with the Department for Education and Skills, chaired by the chief dental officer, we have been looking at how we can expand the number of places. Building completely new dental schools is not necessarily the answer because of timing, but we are considering satellite schools from existing dentistry schools so that where there are access problems we can work with the existing schools to ensure that there is proper training and people can stay in the area once they have graduated.

Peter Tapsell: Is the hon. Lady aware that although the Louth and Horncastle constituency is not an area of deprivation, it is seriously deprived of dentists? There is not a single NHS dentist in my constituency who is prepared to accept a new patient on his list, and as many elderly people constantly move into my constituency to retire that is creating a real crisis.

Rosie Winterton: I am aware of the problems that the hon. Gentleman has outlined. Indeed, I visited the area a few months ago. We are asking each PCT, through the strategic health authority, to produce plans to increase the provision of NHS dentistry. As I said, we have backed that up with £59 million of investment to tackle severe access problems. I know that plans are being drawn up in his area and that international recruitment is also being considered to ease some of the problems. I suggest that the hon. Gentleman contact his PCT to ask for the plans and to ask about the additional resources that it will have been allocated to deal with the current access problems.

Joan Humble: Further to that reply, is my hon. Friend aware of the exciting and innovative plans that Blackpool PCT has recently announced to recruit more dentists? What advice and support can she give the PCT to ensure that those plans come to fruition?

Rosie Winterton: I am certainly aware of the plans proposed by Blackpool PCT. We have already allocated £192,000 to the PCT in my hon. Friend's constituency to ease the problems there. The PCT is considering not only bursary schemes for new students, but making funding available to dentists to expand their premises, for example, or to buy new equipment. It has set up a very good helpline locally to ensure that people have proper information about what is available. Already, that has meant that 4,000 new registrations are available to local people. We will continue to do all that we can to assist her local PCT, and if we can give assistance in terms of international recruitment, we will certainly do so.

Andrew Lansley: When the Minister was replying to the hon. Member for Great Yarmouth (Mr. Wright), she neglected to tell him about the situation in Great Yarmouth—there are fewer dentists today than in 1997, 10 per cent. less of the adult population is registered with an NHS dentist, and if people who live in Great Yarmouth wish to register with an NHS dentist they must go to Lowestoft to do so. Will the hon. Lady simply tell the House whether, when the Prime Minister said in 1999 that within two years everyone would be able to see an NHS dentist, he meant that, five and a half years on, 39 per cent. of the British public would be registered with an NHS dentist? Dentistry is simply disappearing throughout the country, as we are hearing from hon. Members.

Rosie Winterton: It is bit rich of the hon. Gentleman to wash his hands of responsibility. The Conservative party closed two dental schools and introduced the deeply unpopular contract in the 1990s that led to dentists walking away from the NHS. We are trying to reform the system of dentistry and we are backing that up with extra investment. I am very well aware of the problems that my hon. Friend's constituency has faced. That is exactly why we have taken the measures that we proposed and exactly why those involved are now looking to recruit 14 new dentists for his constituency.
	We will take no lecture from the Opposition about NHS dentistry. We are trying to clear up the mess that they left behind, and we are making good progress in doing so. There is further to go, but we have made clear commitments through extra investment, local access plans and ensuring that there will be local commissioning of NHS dentistry in future.

Andrew Lansley: The hon. Lady and her friends will have to take a lecture from the British electorate before too long. On 7 December, on the last occasion that we were present for Health questions, she said that the general dental services contract was on course. Within a month, the Government had to abandon that, so it has been delayed further. She said that dentists were voting with their feet, but I do not think that she meant that, three hours after Ministers came to the House, the British Dental Association would walk out of negotiations on the contract with the Government.
	It is fine for the Minister to talk about the contract in the last century, but what about the contract for the 21st century? When the BDA walked away, it said:
	"This was a decision we never wished to make and it is a highly regrettable position to find ourselves in. We have been proactive in our discussions with the Department of Health but the traffic has almost been entirely one way. To continue would be to devalue NHS dentistry and to let down the dentists we represent."
	Under this Government, NHS dentistry is devalued and dentists are let down—[Interruption.]

Mr. Speaker: Order. We are still on Question 1. I appeal for brief questions and brief answers.

Rosie Winterton: We do not deny that problems remain with NHS dentistry, but we are taking radical steps to reform it and to introduce local commissioning. We have responded to the points made by the National Audit Office report and said that we will delay the implementation of the new contract until April 2006. That does not mean that dentists are not already moving over because some 3,500 have taken up the new contract. We have 500 applications in the pipeline and want to ensure that they are processed before we move to general commissioning. After our announcement last week, John Renshaw, the chair of the BDA, said:
	"This is a sensible move by the Department of Health, which could provide breathing space to allow us to sit down again and resolve outstanding issues."
	I do not think that that sounds like a vote of no confidence.

Peter Pike: My hon. Friend knows that Burnley is an area of deprivation. It also has a big shortage of NHS dentists and a record of poor dental health. She has visited east Lancashire and knows that its primary care trusts are working with the Government to try to address those problems. However, I am sure that she will be dismayed to hear that last week the Taylor dental practice on Colne road in Burnley decided to leave the NHS. Will she check with the PCT about why things are working in the opposite direction to what it and she are trying to achieve?

Rosie Winterton: I will certainly check on that. When I visited my hon. Friend's area, it was obvious that the PCT had good plans that were backed up with extra resources. I think that some 40,000 extra registrations are planned throughout east Lancashire. I know that the plans are there, but I shall certainly examine his point about a specific dentist moving out of the NHS and find out whether we can do anything to rectify that situation.

Paul Burstow: The number of children registered with NHS dentists has fallen every year since the last general election. Today, little more than a half of children are registered with an NHS dentist—the number is lower still in some of the poorest areas. Does the Minister agree that given that the BDA walked out of the contract negotiations and that primary care trusts are not up to the job of delivering dental services, the Government's approach is not radical, as the Minister would like the House to believe, but ramshackle and it is not delivering good dental services? The approach is complacent, which is consequently doing harm to the nation's teeth.

Rosie Winterton: The hon. Gentleman is quite wrong to say that local PCTs are not getting on with the job of moving people on to the new contract because they are already doing that. It does him no credit to decry local efforts that are backed up by extra funding. People are working extremely hard to draw up local plans, which are backed by funding. There are more dentists than ever before—and although there is a problem with some moving away from the NHS, we are undertaking reform so that funds and powers exist locally to ensure that there is proper NHS dentistry provision.

Chiropody Services

Marion Roe: What assessment he has made of the availability of chiropody services for senior citizens.

Stephen Ladyman: There are 3,807 chiropodists employed in the NHS, which is a 15.9 per cent. increase since 1997. It is for local primary care trusts to determine local priorities for access to chiropody.

Marion Roe: I am grateful to the Minister for that reply, but will he give the House his estimate of the number of patients with foot problems who have been deemed to be low risk and thus discharged from NHS care and forced to look in the voluntary and private sectors to find the specialist chiropody services that they need? What plans does he have to draw up guidelines on the management and treatment of foot problems to lay down a patient's minimum entitlement to NHS care and remove the current postcode lottery of entitlement to foot care?

Stephen Ladyman: Once upon a time there was such guidance on who should have access to chiropody services, but it was scrapped in 1994 under the previous Government. We have simply moved to a situation in which local primary care trusts are responsible for ensuring that everyone in their areas has access to the foot care that they need. Most PCTs are concentrating specialist problems on specialist chiropodists and thus leaving other organisations, such as those in the voluntary sector, to deal with less specialist needs, but each PCT has the responsibility to ensure that everyone in its area has access to the appropriate foot care.

Anne Begg: A number of senior citizens go to private chiropodists for their care. Has my hon. Friend assessed how many of those chiropodists will fail to register with the new Health Professions Council? One chiropodist in my constituency said that the process is very bureaucratic and expensive. My constituent would like to see automatic registration for anyone who has three years' experience. He thinks that the number of practising chiropodists will fall because they will no longer be able to practise under that title. That might cause a crisis and, obviously, difficulties for those who are receiving treatment under the NHS as well.

Stephen Ladyman: I understand the issue that my hon. Friend raises. These are matters, first, for the Health Professions Council. More importantly, they are negotiated closely with the professional bodies representing chiropodists and podiatrists. We try to meet their registration needs. Although individual chiropodists may have views about the democratic nature of the requirements for registration, I can assure my hon. Friend that the professional bodies that represent podiatrists are having their views closely adhered to by those who have to implement these arrangements.

Julie Kirkbride: Can the Minister explain why over the years since Labour came to power fewer people have had access to NHS chiropody services?

Stephen Ladyman: I can certainly do that. The figures are roughly similar to the number of new starts in each year since we came to power. The total number of procedures carried out each year is roughly the same. There is a slight decrease, and that entirely reflects the fact that more specialist podiatrists are concentrating on specialist processes that take longer than the old, simple foot care procedures that are now being undertaken by people who are not specialists. That is good value for money. The assertions of Opposition Members that there is a massive removal of people from NHS podiatry services is simply not true. Like the Opposition's announcements yesterday from the shadow Chancellor of the Exchequer, their figures just do not add up.

Rob Marris: Can my hon. Friend assure me that we have enough training places for chiropodists and podiatrists?

Stephen Ladyman: I can give my hon. Friend that assurance. Since 1997, there has been a 33 per cent. increase in the number of people training for this speciality.

Hospitals (Gloucestershire)

Parmjit Dhanda: If he will make a statement on progress with hospital new build projects in Gloucestershire.

John Reid: The new Gloucestershire Royal hospital became operational two months ago. A final phase of works of this £32 million investment is due for completion this year.

Parmjit Dhanda: I thank my right hon. Friend for his response. He is aware that the new hospital is a £32 million redevelopment project and consists of 17,000 sq m, something that we are understandably proud of in Gloucester. It has enabled me to become the first local Member in Gloucester in a generation to preside over hospital ward openings rather than closures. Would my hon. Friend take up an invitation from me to see the hospital for himself? I think that it would be the right thing to do. It would pay testament to a Labour Government and their priorities if a Labour Secretary of State opened the new hospital. Will he consider coming to Gloucester to do that?

John Reid: I would be delighted to visit once again my hon. Friend's constituency, as I did in June last year. Before I get any other requests, it will not be possible for me to open all the hospitals commissioned by the Government. There are not enough weeks in the year as we have now commissioned 132 new hospital projects—the biggest building programme ever in the history of the NHS. That is one of the reasons why we are slashing waiting lists and waiting times and providing better quality care than ever before. We have a long way to go, but my hon. Friend's constituency exhibits, I think, the transformation that is now taking place in the NHS.

Laurence Robertson: If the Secretary of State visits Gloucester Royal hospital, will he also visit Cheltenham hospital, which is facing the closure of the children's ward in terms of 24-hour clinical care? I do not rise to make a political point, but I think that it is worth mentioning that closure in view of the previous question. The primary care trust is pushing the transfer of the ward to Gloucester on a clinical basis, and recently there have been clinical questions raised about that transfer. I do not expect an immediate answer from the Secretary of State, but will he look into that matter? Will he satisfy himself that it would be in the wider interests of all the children in Gloucestershire for that move to take place, and will he endeavour to write to me about it?

John Reid: May I make two general remarks to the hon. Gentleman? First, it would have been a little fairer if he had announced that, quite apart from any changes in his constituency, there is an unprecedented increase in the finance going into the national health service there. Secondly, on the decision and the proposed changes, the constant refrain, quite correctly, from the Opposition and their Front-Bench team is that we should stop micro-managing the NHS and let local people make local decisions—except when Conservative MPs do not agree with those decisions, when they ask us to intervene in every case.
	I will take a look at this case, but my general predisposition is that, as far as possible, front-line staff should be allowed to get on with making those decisions in consultation with local people, which is why we now allocate 80 per cent. of the money going into the NHS to front-line staff. I should have thought that the hon. Gentleman and his colleagues, who are always asking for that, would support it when it is put into practice.

Alcohol Misuse

Sandra Gidley: If he will make a statement on the Government's policies to tackle alcohol misuse.

Melanie Johnson: On 15 March 2004, the Government published the alcohol harm reduction strategy for England. The Department of Health and the Home Office are the joint owners of that strategy. The White Paper, "Choosing Health", which was published on 16 November 2004, highlighted additional commitments that build on the strategy.

Sandra Gidley: We are all aware that the Government have sexed down the alcohol reduction strategy, but could she explain a serious omission, as there is no mention of older people, among whom there is a growing problem of alcohol misuse? Is that yet another example of NHS ageism, or is it because older people do not present such a high profile problem on a Saturday evening at club and pub chucking-out time?

Melanie Johnson: What we are doing, both through the alcohol harm reduction strategy and the White Paper, is to concentrate on finding out how much more treatment needs to be provided, and an audit is under way. We are also making interventions in primary and hospital settings to work out how we can better target people of all ages with alcohol problems who are using those services. Much of the improvement across the board in health services has helped elderly people as much as, if not more than, the rest of the population.

David Winnick: Is my hon. Friend aware that a recent report showed that one in four emergency hospital admissions for men is alcohol related? Alcohol plays a part in about half the number of serious road crashes and half of domestic violence incidents. In view of all that, does she agree that the Department of Health should be concerned about plans significantly to extend pub opening hours, which could lead to some pubs being open both day and night for 20 or 24 hours?

Melanie Johnson: I am sure that my hon. Friend has seen an article in one of today's newspaper suggesting that we suppressed a report about the number of accident and emergency attendances that are alcohol related. In fact, it is completely untrue. [Interruption.] I am coming on to the related point that my hon. Friend made. Page 36 of the alcohol harm reduction strategy identifies the problem with reference to research commissioned by the strategy unit, and page 149 of the White Paper puts the same information into the public domain. I can reassure my hon. Friend that we are well aware of the problems in A and E departments resulting from alcohol, which is why we are looking at targeted interventions. We are working with the chief medical officer and the chief nursing officer on the curriculum, guidance and training for health service professionals so that we can deal better with people who come to the NHS the worse for alcohol.

Simon Burns: May I press the Minister to pick up on the question from the hon. Member for Walsall, North (David Winnick), which she singularly failed to answer? Given the problems facing the health service because of alcohol-fuelled abuses and, in addition, attacks on NHS staff, particularly in accident and emergency departments, will the Minister share with the House the information or advice that the Department of Health gave the Home Office when it was considering relaxing the laws on licensing to allow 24-hour drinking? Does the Minister agree with her right hon. Friend the former Home Secretary who, it now transpires, did not agree with that legislation, even though his Department was responsible for it?

Melanie Johnson: I agree with the Government. We are all aware that there are problems arising from binge drinking. That is why we are the first Government to set out a harm reduction strategy, and the first Government to produce a comprehensive White Paper—[Interruption.]

Mr. Speaker: Order. Hon. Members should be quiet.

Melanie Johnson: Thank you, Mr. Speaker.
	We are the first Government to produce a White Paper that examines the problems arising from alcohol. My right hon. and hon. Friends in the Home Office have been tackling the disorder consequences of binge drinking with measures such as fixed-penalty fines, additional fixed-penalty fines, enforcement campaigns and new laws to close down premises if under-age sales occur. That is on top of the measures that we are taking in the health service. We all accept that more work is needed to clamp down on binge drinking. The problem is already with us and it has a long history. We have instituted the measures that will tackle the problem.

Julia Drown: I am grateful to my hon. Friend for meeting me and one of the leading consultants from the Great Western hospital who deals with the results of alcohol misuse and sees patients dying on our wards each day because of alcohol misuse.
	Does my hon. Friend support the measures that doctors are pushing for—alcohol warnings on bottles so that people know how much alcohol they are consuming; alcohol specialist nurses in our acute hospitals so that they can tackle people at the point at which they are potentially willing to change their mind, following an acute admission; and more education in schools about the damage that alcohol can cause to a person, their whole family and their friends?

Melanie Johnson: We support a range of measures that my hon. Friend is probably aware of, including a new sensible drinking message based on research into how we change behaviour, targeting the interventions that I mentioned a moment ago in primary and hospital settings, and better advice and training for professionals. We also recognise that we need to do more about education on alcohol. All these topics form the basis of the alcohol harm reduction strategy that I mentioned.

Foundation Hospitals

Piara S Khabra: If he will make a statement on the number of hospitals that have obtained foundation status; and how many applications are pending.

John Reid: I have today announced that 32 more trusts, which for the first time include mental health trusts, have been successful in their preliminary application for NHS foundation trust status. Decisions on the next phase of the applications are scheduled for the autumn of this year, after I have had the opportunity fully to consider the outcome of the review of the policy by the Healthcare Commission. Twenty-five acute and specialist NHS trusts have so far been awarded NHS foundation trust status. A further group of 10 trusts are seeking authorisation this April.

Piara S Khabra: Has there been any measurable improvement in the waiting lists for hospitals already granted foundation status, and is there any hope of improvement in the future?

John Reid: Indeed, in many cases foundation status has meant a dramatic reduction in waiting lists and waiting times. Of course, it is true that right across the national health service there has been a significant reduction in any case, as a result of, first, decentralising decision-making to the front line and, secondly, introducing the prospect of more patient power and choice of provider, allied with the investment that the Government have put in. So the capacity and the reform, including NHS foundation trusts, have resulted in more, quicker and better quality health care for most people. I recognise that there is still a long way to go, but I promise that this Government, God and the electorate willing, will continue to improve—[Laughter.] It appears that Conservative Front Benchers believe in neither of those two personages, but I assure them that both will sit in judgment on the Conservative party in due course.

Chris Grayling: May I seek a point of clarification? Are the Government willing in principle, subject, obviously, to all the quality issues that arise, to consider an application for a foundation trust that wraps together secondary and acute care, with some primary care services, too?

John Reid: At this stage, we have extended just from acute secondary care to mental health trusts. The hon. Gentleman might know that we have commissioned a review of the early experience of foundation trust status, which will be carried out by the Healthcare Commission and will, no doubt, examine extending such opportunities further. In general, however, the principles of a diversity of providers, decentralising power to the front line as far as possible and, crucially, giving patients more information and power in relation to which provider they choose, whether in the secondary or primary sector, are an integral part of our reform programme.
	Most Members on both sides of the House share the principles that I have outlined, but there is one other principle that, I am afraid, divides us—that people in this country, in line with the founding principle of the national health service, which they still support, should continue to have equal access to health care, free at the point of need. We are absolutely committed to that, and we absolutely refute charging for any operations through the national health service, which is the proposal—[Interruption.] As Conservative Members are trying to intervene, let me read from their document on the right to choose—[Interruption.]

Mr. Speaker: Order.

David Hinchliffe: One of the positive aspects of foundation status was the devolving of local decision making to local people, enabling local people democratically to elect those who run foundation trusts. What steps have the Government taken to analyse what happened in Bradford, where the locally elected chairman, a popular local figure, has been removed by the regulator, and people have come in from New York—some distance from Bradford—to run the foundation trust?

John Reid: The matter is being investigated by Monitor, the organisation that was established precisely to ensure that foundation trusts—we hope that all hospitals will obtain foundation status in future—comply with rigorous financial inspections. I would therefore prefer to leave it to that organisation, and to say only that this is not an aberration—Monitor was set up to discover exactly where hospitals are running huge financial risk. In previous decades, before we set up the organisation, that could have gone on for some considerable time. The expectation then was that the rest of the system would bail out those who found themselves in that position. I am afraid that we can no longer tolerate that. Along with the rights to make decisions at the front line, people must accept the responsibility to run a rigorous, financially viable organisation. We expect that of all, not just Bradford.

John Wilkinson: Does the Secretary of State intend to add to the number that he has quoted by the designation of foundation status to the new hospital that he plans to build in the Paddington basin, combining the Royal Brompton, the Harefield and St. Mary's hospital, at a cost of more than £1 billion, without planning permission, and for which the outline business case required by the National Audit Office seems to indicate that it will not be in service until 2013?

John Reid: To suggest that the NHS would plough ahead with any project, whether it costs £1 or £1 billion, without planning permission is to stretch the credulity of the House. As far as foundation status is concerned, I can confirm two things: first, we intend all NHS trusts to get foundation status; secondly, the services that NHS trusts provide will be free at the point of need. We do not intend to allow 50 per cent. of the NHS tariff to be used where hospitals charge patients—those are the words of the Conservative party, which I was trying to quote earlier.

Gisela Stuart: I welcome the announcement that another hospital in Birmingham has been granted foundation status. The hospital in my constituency was granted foundation status last year, and patient services have improved. Will the Secretary of State ensure that the hospitals in the new round use the financial freedoms that they have been granted to benefit patients in their localities and to build on services? They have been given the power and should use those freedoms.

John Reid: I hope that that will increasingly be the case. Seven of the 20 NHS foundation trusts are already using their borrowing freedoms to fast-track capital projects, and seven of the 20 are already using non-capital freedoms to extend patient choice projects. The proof of the pudding is in the eating: we now have 450,000 more operations every year; we have halved the maximum waiting time for operations and will halve it again over the next three years; and we have taken 314,000 people off the waiting list that we inherited from the Conservative party. Let us not pretend that everything is perfect, but let us not pretend that substantial and significant progress has not been made in the NHS.

Patient Choice

Bill O'Brien: If he will make a statement on recent guidelines issued to primary care trusts on patient choice.

John Reid: Recent guidelines have set out a framework that gives patients greater choice of where to have their treatment. Patients will be able to choose to go to hospitals offering faster access to treatment, offering a fairer system to everyone.

Bill O'Brien: I have been asked to bring this case to the House on behalf of Mrs. Mayfield, who has been denied choice. She had the choice between a hospital in Wakefield or a hospital in Leeds, and the PCT directed that she should be treated in Leeds, which meant a 36-mile round trip in the ambulance provided by the PCT. Mrs. Mayfield has recently undergone tests at Clayton hospital in Wakefield and is now waiting for further treatment. If that treatment can be provided at Pinderfields hospital, will my right hon. Friend assure me that Mrs. Mayfield will be able to choose the hospital in Wakefield rather than the hospital in Leeds?

John Reid: I thank my hon. Friend for giving me notice of his question through one of my hon. Friends. For obvious reasons, I am reluctant to discuss individual cases by name on the Floor of the House, but I shall make a general point and go as far as I can on the individual case. Although we want to give greater power and choice to the patient, it must be in the context of national standards and best medical practice. For example, a local constituent who is receiving treatment for rheumatoid arthritis must be offered treatment within the guidelines outlined by the best clinical advice. West Yorkshire PCTs have decided to commission that particular service from Leeds Teaching Hospitals NHS trust because they want to meet the guidelines issued by the National Institute for Clinical Excellence, which has a worldwide reputation for guidance on best treatment. The NICE guidelines state that the prescription of the agents that some patients with rheumatoid arthritis have to receive
	"should be undertaken by a consultant rheumatologist specialising in their use".
	In my hon. Friend's local area, the consultant who specialises in their use is currently situated at Leeds hospital. This is being done with the best of intentions, best practice and best medical guidelines. My comments will be noticed, and I am sure that the local authorities will consider whether there is any way of making the service even more convenient.

Peter Lilley: May I congratulate the Secretary of State on his U-turn on patient choice in the health service? Does he regret that the initial policy of the Labour party was to remove patient choice, to stop money following patient choice and to abolish what it derided as the internal market? Is it not a shame that for seven years we have had no patient choice—and consequently nothing driving up efficiency and improvements—and hence there has been so much money spent and so much waste? I welcome the Secretary of State's belated, inadequate and over-bureaucratic conversion to patient choice.

John Reid: I thank the right hon. Gentleman for his congratulations and wish him a happy new year, along with everybody else on the Opposition Benches.
	It is certainly true that when one introduces real choice, as opposed to the theoretical choice that we all possess to buy a Rolls-Royce or dine at the Ritz, it has to be made real by increasing capacity and investment. The right hon. Gentleman is right that for the first two years of our Government, from 1997 to around 1999, we did not increase that investment and stuck to the Tory spending plans, for the very good strategic reasons that we wanted to create a stable economy, reduce unemployment and so on. In that context, we did not introduce a great deal of reform. Obviously, I would have liked to do it earlier.
	Nevertheless, I welcome the fact that the right hon. Gentleman welcomes the fact that we are now doing this and doing it robustly. I only hope that he also welcomes the fact that we are doing it within a context in which we are retaining the founding principle of the national health service—that all care will be free at the point of need. Would he and his colleagues concur with me on that important principle?

Brian Jenkins: I recall that at the time when I became a Member of Parliament, my local paper carried a front-page headline saying that a man had remortgaged his house in order to be able to afford a heart bypass operation. Today, we are discussing patient choice: what progress we have made. Will my right hon. Friend ensure that when people make such choices they do it in consultation with their GPs and medical practitioners, who can give them guidance on the most appropriate course rather than allowing them to make a misinformed choice?

John Reid: Choice is never an absolute—it is always subject to best medical standards and is only made real if the capacity is put into the system to allow people to compensate for any lack of money in their own pockets. I never again want us to go back to the days when people were forced to spend between £10,000 and £20,000 to get heart bypass operations in a speedy fashion. That is why I am so absolutely opposed to the so-called patient passport plans, which would force people who want a speedy operation to take half the money out of their own pocket. It is an absolute disgrace to undermine the national health service with such charges.

Hospital Wards

Ben Chapman: What his policy is towards the provision of mixed wards in hospitals.

Rosie Winterton: Our policy is that the NHS should provide single-sex accommodation for hospital in-patients, and 97 per cent. of NHS trusts now meet single-sex accommodation standards.

Ben Chapman: I welcome the figure of 97 per cent. None the less, a survey by the National Consumer Council found that shared wards remain a major concern for patients, because they can cause stress and embarrassment to people who are already in a vulnerable situation, whether they be in general wards, emergency wards, short-stay wards or even general wards that have single-sex space. While I recognise that it would cause a loss of flexibility and perhaps a loss of beds, will my hon. Friend ensure that we move from 97 per cent. to 100 per cent. as soon as humanly possible?

Rosie Winterton: Certainly. We are obviously delighted that we exceeded the target for December 2002 for 97 per cent. of in-patient stays in single-sex accommodation. I assure my hon. Friend that we are working towards 100 per cent. In the remaining areas of non-compliance with the guidance, new hospitals and new accommodation are being built. That should overcome the problems and allow us to reach 100 per cent.

Tim Loughton: Back in the heady days of 1996 when the Prime Minister was Leader of the Opposition, he asked,
	"Is it beyond the collective wit of the Government and the health administrators to deal with that problem"—[Official Report, 19 November 1996; Vol. 285, c. 832.]
	of mixed-sex wards?
	Since then, the target for 95 per cent. of single-sex wards by 2002 was missed by an unspecified figure. Subsequently, a new target for April 2004 was not met and the Health Service Journal reported that at least 84 mixed-sex wards still existed and a quarter of mental health patients were in mixed-sex accommodation. The targets do not apply to teenagers. Why does the Minister refuse to name the hospitals that continue to have mixed-sex wards? Eight years after the Prime Minister's initial indignation, will the target turn out to be simply another failed Labour promise from a Minister who is becoming the Minister for failed promises?

Rosie Winterton: The guidance that we use for single-sex accommodation is the same as the guidance that the Conservative Government distributed. That is how we analyse the compliance. We have been unwilling to publish the details of hospitals where there is non-compliance because it does not necessarily mean that the whole hospital is not meeting the required standards. In some areas, hospitals are not reaching the target but there are plans in place to do so. However, I shall consider whether we can publish the information in the near future.

National Programme for IT

Richard Bacon: If he will make a statement on the national programme for IT in the NHS.

John Hutton: Last year, contracts were let within budget and on time for all the major components of the national programme for information technology. The Department of Health is working with local NHS organisations to ensure the effective implementation of those new systems.

Richard Bacon: Why were there only 63 bookings under the choose and book service by the end of December, when the Government, even under the slowed-down timetable, had been expecting 200,000?

John Hutton: There has clearly been a delay in the implementation of choose and book. However, it is important to bear it in mind that we are considering probably the biggest civil IT programme anywhere in the world. I am sure that the hon. Gentleman, who is an expert on such matters, knows that. It is fanciful to suggest that we could implement it with no hiccups and no technical problems. We have never made that claim. The progress on choose and book is slower than I would have preferred but I am confident that, with the other measures that we have recently announced on ensuring that all first out-patient appointments can be booked at a time and place that is convenient to the patient, we can meet our objectives by December 2005.

Andrew Murrison: The director general of the national programme for IT in the NHS is reported as saying that the Government's blueprint for NPfIT had no engineering basis and had to be reverse engineered. Given that NPfIT will cost £300,000 per doctor over 10 years, can the Minister justify the appalling progress on electronic booking? Why is there so much residual concern about the security of electronically held medical records? In retrospect, would not it have been wiser, in all candour, to engage GPs fully from the start in the process? Would not it have been better to utilise existing processes such as EMIS, in which doctors truly have confidence?

John Hutton: I take issue with the hon. Gentleman about his figures. They do not represent the cost of the national programme for IT. Perhaps we can revert to that at a later date. Of course we all agree that engaging front-line clinicians is an important objective. That is why we are working closely with GPs, many of whom have been involved in helping us to design and shape the national programme for IT to serve the purpose that we want it to provide: a more modern, more convenient, more accessible and more error-free NHS. Rather than moan and groan, as the hon. Gentleman always does, I would have hoped that he and his hon. Friends would at least acknowledge that we are establishing a programme that is the right way forward for the NHS and is fundamental to delivering patient choice and improvements in quality. I hope that, at some point, the hon. Gentleman will get on board and support the national programme for IT because it is right for the NHS. It is a difficult programme to get right, but his negative approach is out of place.

NHS Trust Deficits

Archie Norman: What steps he is taking to address financial deficits in NHS trusts.

John Hutton: Strategic health authorities have responsibility for managing the financial performance of NHS trusts in their area. Additional financial support is provided, where necessary, to NHS trusts and primary care trusts through the NHS bank, strategic health authorities and, in exceptional circumstances, the Department of Health.

Archie Norman: Is the Minister aware of the claim in the Health Service Journal that the NHS is deep in the red to the tune of £500 million, and that the usual claim that this will sort itself out by the end of the financial year will no longer wash? Will he acknowledge that, this year, a large proportion of the deficits have been caused by unbudgeted cost overruns on centrally driven initiatives such as the new consultants' contract—which could cost an extra £200 million—the GP contract and the working time directive? Does he also recognise that the British Medical Association is saying that 25 per cent. of NHS trusts have already frozen vacant positions? Does he acknowledge that, this year, there is a real case for funding those deficits directly, where merit-worthy cases can be presented to demonstrate that the fault lies with central Government rather than with faulty planning or budgeting by the trust?

John Hutton: I am certainly aware of the Health Service Journal's predictions about the financial state of the national health service this year. I know that the hon. Gentleman is a strong supporter of the NHS, and I appreciate that. I would like to remind him that the Health Service Journal, Conservative Front Benchers and Liberal Democrat Front Benchers have made predictions about deficits every year, but none has ever proved to be accurate or well founded. Last year, the Lib Dems predicted a £400 million deficit; we actually had a £73 million surplus.

Stephen McCabe: Is it possible to track and address deficits in an NHS devoid of accountants, administrators and strategic health authorities? If not, would it be fair to dismiss these dedicated civil servants as pointless and unnecessary bureaucrats at the stroke of a pen, or would that be to perpetrate a deliberate falsehood on the British public?

John Hutton: I strongly agree with my hon. Friend. When we look at the proposals that are eventually emerging from those on the Conservative Front Bench, we see how utterly threadbare, incredible and ludicrous their arithmetic is. The NHS needs good management; it does not need slash and burn, which is what the Tories are proposing.

Patrick McLoughlin: Will the Minister tell me whether NHS deficits have anything to do with the fact that Ebixa, a drug used to treat Alzheimer's disease, is available in Ashfield but not in Ashbourne?

John Hutton: I accept that there are issues there, and it is perfectly fair of the hon. Gentleman to raise them, although we have taken concrete, specific and successful measures to deal with the lottery of care that we inherited in 1997. We shall need to wait and see what the true position on NHS deficits is at the year end, but it will bear no resemblance to the figures that the hon. Member for Tunbridge Wells (Mr. Norman) has just quoted.

Waiting Lists

Nick Palmer: What progress has been made since 1997 on reducing waiting lists for hospital treatment.

John Reid: Since 1997, we have cut waiting lists by 314,000, or 27.1 per cent. This is the lowest level since comparable data were first collected in September 1987.

Nick Palmer: I thank my right hon. Friend for his response. I welcome that progress, and today's announcement that two of the Nottingham trusts, including one mental health care trust, have been given foundation status will further accelerate that progress. Does my right hon. Friend agree, however, that although health care professionals are virtually unanimous in saying that there has been enormous progress, the public are still unsure? We really need to focus on the total waiting time from the patient's first contact with their GP to the time at which they get their treatment. Only then will we really make a breakthrough in regard to public confidence.

John Reid: I agree with my hon. Friend. Substantial progress has been made. In 1997, 284,000 patients were waiting more than six months for operations; that number has been slashed to 62,000, and over the year it will be reduced to zero. For 60 years, however, we have measured the six months as starting from the time of diagnosis, not from the time when a GP was first consulted. The Labour Government will get rid of those hidden waits. I have pledged that by 2008 we will measure the time from the GP's door to the door of the operating theatre, and that it will be a maximum not of years, as it was under the last Government, but of 18 weeks. That, I think, will show a truly transformed NHS.

Orders of the Day
	 — 
	Drugs Bill

Order for Second Reading read.

Charles Clarke: I beg to move, That the Bill be now read a Second time. It gives me great pleasure to do so.
	This is an important opportunity to consider a Bill in the context of our overall drugs strategy. I am delighted to say that during the Queen's Speech debate there was broad cross-party support for it, and many of the provisions were discussed following consultation on police powers and publication of a progress update in November. I am sure that that discussion will continue in Committee, and the Government will welcome constructive proposals from members of all parties in that same spirit of broad cross-party support.
	We have welcomed the feedback from our consultation, and we have worked closely with the police to develop the powers that are needed and for which the police themselves have asked. Those powers are designed to increase the ability of the police and the courts to tackle drug dealers, and to secure a measured and proportionate response in the tackling of harm caused by class A drugs that complements the drugs strategy that has operated since 1998. The strategy has focused on a number of key targets. It aims to reduce the harm that drugs cause to communities, individuals and families, on the basis of what actually works, and to tackle problems from every possible angle, involving all public services and voluntary and community activity. I think that we are starting to see positive results.

Desmond Swayne: The price of drugs has fallen dramatically. That disincentive seems to have been removed. Meanwhile, the reclassification of cannabis, the entry drug of choice, has left consumers—if we can call them that—with a mixed message: that they will not be prosecuted for holding supplies for their own consumption, but that the supply remains entirely in criminal hands. Is that not the worst of all possible worlds?

Charles Clarke: I do not think that there is a mixed message. On the contrary, the message is very clear. People should not consume drugs, and we as a Government will work with all the agencies to try to ensure that they do not. It is true that the price is too low in some cases, which is to do with the balance between supply and demand. I shall say something about that in a moment. The hon. Gentleman has raised an important issue, on which we are focusing strongly.

Paul Flynn: During a debate in the Chamber in 1998, all parties agreed on a 10-year strategy whose main aim was to reduce the consumption of all illegal drugs. Will the Home Secretary tell me by how much consumption has been reduced in the seven years that have elapsed since then?

Charles Clarke: Cannabis use among 16 to 24-year-olds is down from 28.2 per cent. in 1998 to 24.8 per cent. Amphetamine use has fallen by 60 per cent. in the last five years. Ecstasy use has also fallen over the last two years. We are making progress, and I think that that is a result of our policies.

Paul Flynn: Will the Home Secretary give way?

Charles Clarke: I will in a moment.
	The hon. Member for New Forest, West (Mr. Swayne) mentioned drugs gangs, of which more than 330 were disrupted in the 18 months to December 2003, since the updated drugs strategy. Some 150 crack houses were closed between January and September under the new powers that this Parliament has given to police forces. Some 8,000 misusing offenders entered treatment through the drugs intervention programme between April 2003 and September 2004. Nearly 26,000 drug treatment and testing orders have been issued since their introduction. On average, offenders committed 75 per cent. fewer offences while on such orders, and they reduced their spend on drugs—this point also relates to the intervention by the hon. Member for New Forest, West—by more than 90 per cent. Fifty-four per cent. more users are in treatment compared with 1998 and waiting times for treatment are down by 71 per cent. compared with the 2001 figure. Drug-related deaths are at their lowest level since 1998 and for every pound spent on treatment, £3 is saved on criminal justice costs.
	The extremely important point that I am seeking to make is that none of us in this House should regard the fight against drug use as a hopeless struggle. We have made significant progress as a result of putting our strategy in place. There is, as both interventions have acknowledged, a need to make a great deal more progress and I believe that the Bill will help us to achieve that end.
	I turn to the Bill's key points, which I shall go through steadily. By way of general introduction, I should mention the concerns that have been expressed about civil liberties. I want to make unequivocally clear the Government's view that it is the drug abuser who threatens the civil liberties of the law-abiding citizen, rather than the reverse, which is why we need to take legal powers to ensure that the state can prevent and inhibit drug abuse. That requires the kind of measures contained in the Bill, in order to ensure that the immense damage that drug abusers do not only to themselves but to society as a whole is prevented and driven out. We are building on a foundation of steady progress, but we need to go still further.
	What does the Bill seek to do? Clause 1 puts in place aggravating factors in respect of supply of a controlled drug by a person aged over 18. For example, where supply takes place within the vicinity of a school and during the relevant time, or where a dealer uses a person aged under 18 as a courier for drugs or for drugs money, the penalties for such an offence will increase very substantially, for reasons that I hope are obvious to the House.

John Mann: How many recorded incidents are there of drug arrests in the vicinity of schools, and of subsequent convictions, in the past few years?

Charles Clarke: We do not have the detailed information that my hon. Friend seeks, but anecdotal evidence and comments from many of the agencies concerned suggest that this is an issue that we have to address. Indeed, it would be absolutely wrong of this House not to acknowledge that the supply of drugs in and around schools in some parts of the country is a serious issue. My hon. Friend has rightly developed a strong reputation for his work on this problem and taking the necessary powers through this Bill will enable us to attack it even more strongly.

John Mann: A slight amendment to the wording of the relevant provision might solve the Home Secretary's problem. Several hundred of the 3,000 constituents who wrote to me in response to my heroin inquiry suggested that drug dealing was taking place in the vicinity of local schools. We investigated every single complaint, but we could find evidence of only one such incident throughout the preceding 10 years. The reason was explained by the school pupils. Many of them said, "Why would we be so stupid as to buy drugs in or around the school and use them there, when we can buy and use them in social settings at will?"

Charles Clarke: I understand the point that my hon. Friend makes, but his survey illustrates that this is a real issue. Let me give another example. A couple of years ago, an Opposition Member asked me to meet the head of a big secondary school in his rural constituency. That head said that he shared precisely these concerns about drug dealers operating in school environs. We must be very clear that that is not an acceptable way to behave. Similarly, where a dealer uses a person under the age of 18 as a courier for drugs or drugs money, that should also be regarded as an aggravation of the offence.

Brian Iddon: I understand that aggravated supply is covered by the current arrangements in the courts, in that the judge can already take aggravated circumstances into consideration, so why does my right hon. Friend believe that clause 1 is so necessary?

Charles Clarke: My hon. Friend is right that a judge can take aggravated circumstances into account, but they do not include the particular aggravations dealt with in the Bill. That is why it is so important for us to set out the provision in the Bill.

Angela Watkinson: Does the Secretary of State agree that the best way to reduce demand for drugs among school-age children is to change the style and content of education in schools away from the provision of information and harm reduction to drug prevention?

Charles Clarke: I agree, but I can say, on the basis of my experience, that the work done in schools on personal and health education, which includes sex and drug education, is outstanding and it works in precisely the way that the hon. Lady highlighted. One of my aims in our drugs strategy, working in collaboration with the Secretary of State for Education and Skills, is precisely to develop and enhance the sort of work that will inhibit drug abuse by young people. I believe that that is one of the main reasons why the incidence of drug abuse among young people has gone down.

Alistair Carmichael: To follow up some of the points made by Labour Members, if we accept that we are dealing with a mischief that requires solution and that a statement of aggravation will be relevant to the determination of a sentence, would it not be sensible to make it mandatory for the sentencing judge to specify that portion of the sentence that is attributable to the aggravation?

Charles Clarke: That is the sort of detail that we can consider further in Committee and I can give a commitment that we will consider that point. However, I do not immediately see the benefit that would arise from that approach. What we are trying to establish is that aspects of drug dealing and drug activity—for example, carrying out such activities in the vicinity of a school—will aggravate the offence, thereby inviting a larger penalty for so doing. If the hon. Gentleman is suggesting that a particular judicial device may be appropriate, we can certainly debate it in Committee and take the matter forward.
	Clause 2 establishes a presumption of intent to supply where the defendant is in possession of a particular amount of a controlled drug. Where the presumption applies, a court or jury must assume that the defendant intended to supply the drug. That is to say, it is not a matter of so-called personal use. The particular level will vary from drug to drug and will be prescribed in regulations, which will need to be approved by a resolution of both Houses, based on the advice of the Advisory Committee on the Misuse of Drugs. The purpose of the clause is self-evident—that it is important to clarify the point at which the quantity of drugs in a person's possession becomes above and beyond that reasonably held for personal use.
	Clauses 3 to 6 and 8 give the police and the courts powers to tackle drug dealers who swallow or conceal drugs on their bodies to evade arrest. Once again, the provision deals with a straightforward and clear point. Some people such as drug dealers seek, for obvious reasons, to conceal the evidence of their crimes and they take a number of steps to do that. The Police and Criminal Evidence Act 1984 allows for intimate search, and the consent of the detainee is not required under the Act. Intimate searches must be undertaken by a registered medical practitioner or nurse and will not normally be undertaken without the suspect's consent. Some suspects withhold consent to evade detection.
	Clauses 5 and 6 enable a police officer to authorise an X-ray or ultrasound scan of a person arrested and suspected of swallowing a class A drug. The court and jury will be entitled to draw inferences where consent to search, X-ray or ultrasound is refused without good cause.

John Bercow: I hope that the Secretary of State will not mind pressing the rewind button, but I want to go back over important territory that he has covered already. He has just described clause 2, which is about strengthening the legal position. Many schools now have zero-tolerance policies in respect of drugs, but in a constituency case of mine the anecdotal evidence in respect of quantity suggested to the head teacher that the child concerned intended to supply drugs. What discussions has the right hon. Gentleman had, or intend to have, with the Secretary of State for Education and Skills about the guidance that might be issued to schools that are nervous about their legal position but anxious to secure help for offenders and protect the other children in the school?

Charles Clarke: Even on rewind, the hon. Gentleman puts his finger on a very important point. Since I became Home Secretary, I have not had a bilateral meeting with my right hon. Friend the Secretary of State for Education and Skills. However, when I was Secretary of State for Education and Skills, I did have such a meeting with my colleague, the former Home Secretary. In addition, other ministerial colleagues and officials are discussing these matters and I can assure the hon. Gentleman that, between us, we will provide guidance that is clear and agreed across Government. In that way, the head teacher in the case that he described would not have conflicting guidance coming from the Home Office, the Department for Education and Skills and various other people. Our unified guidance will better enable head teachers to make the necessary judgments in such cases.
	Clause 8 gives the court power to remand a suspect in police custody for up to 192 hours after charging to allow time for evidence to pass through the body. That is a simple consequence of the change that I set out earlier.
	I turn now to treatment and how we will ensure that the criminal justice system deals properly with the core problem. Clause 7 amends the Police and Criminal Evidence Act to extend the existing power to test for specified class A drugs on charge and provides that such a test can be carried out on arrest. That will give police the discretionary power to test people arrested for those trigger offences most closely associated with class A drug misuse. Where the police, at least at the level of police inspector, have reasonable grounds to suspect that class A drugs were a factor in an offence, they will also be able to test in respect of any other offence.
	We believe that that is central to helping identify drug abusers at an earlier stage of their contact with the criminal justice system—that is, on arrest rather than at charge. In that way, they could be steered into treatment at the earliest possible moment. The power will apply to people aged 18 and over, but provision exists for the age to be changed through secondary legislation, in line with current provisions for testing on charge. Testing on charge has been shown to work well in conjunction with the arrest, referral and treatment services and testing on arrest will ensure that drug misusers not charged with an offence are nevertheless identified and directed to treatment.

Joan Walley: My right hon. Friend mentioned the talks that he hopes to have with the Secretary of State for Education and Skills, but will he say something about the talks that he has had with the Secretary of State for Health? If we are to ensure that people are directed to treatment, it is essential that every constituency in the country can provide that. I am worried that people currently in prison may not be willing to accept treatment. Will he say how we can ensure that people are matched to treatment and that they get the support and health provision that they need?

Charles Clarke: My hon. Friend is correct. She will know that the relationship between me, as Home Secretary, and my right hon. Friend the Secretary of State for Health is institutionally very close in this matter. The National Treatment Agency is an NHS body, but it is responsible both to me and to the Secretary of State for Health. The key issue for the agency is to build the capacity to which my hon. Friend referred in communities up and down the country. Since I became Home Secretary, I have not had a bilateral meeting with the Secretary of State for Health, although I will have one shortly. However, I and my colleagues have participated in a full presentation and discussion of the way in which, over the past two or three years, the NTA has been able to build up the availability of treatment. That is one of the factors behind the figure that I mentioned earlier for the reduction in waiting times for particular forms of treatment. The truth is that although we have made some good progress, there is still a long way to go. However, I can give my hon. Friend the assurance that we are committed to reaching that point.

John Mann: My right hon. Friend has mentioned treatment, but is there any chronic, relapsing disease other than drug addiction that those who provide the treatment paid for by the state need have no medical qualification to do so? Is there any other condition that I could set myself up to treat and potentially receive money from his Department for doing so?

Charles Clarke: That is an important and difficult question. When the National Treatment Agency was established—I was a junior Minister in the Department at the time and involved in the discussions—there was much controversy about whether the appropriate form of treatment for particular conditions at particular times was medical or not. A range of provision existed around the country. One of the aims of the NTA was gradually to reach an agreement about the best form of treatment—medical and non-medical—for certain conditions. Since being appointed, I have asked the question that my hon. Friend asks, and I believe that we are closer to being clear about the best form of treatment for particular conditions.

Iain Duncan Smith: I have spent much time in the past few months visiting many centres in the inner cities that deal with drug rehabilitation, and I have identified some serious problems with the way in which the Government are currently thinking about the issue. For a start, they need to stop talking about treatment and start talking about rehabilitation. Treatment includes detoxing, and that is a temporary affair at best. Rehabilitation is the only way ahead. The Secretary of State should look further than what is happening in Britain, because some other countries are way ahead of us. Sweden is a classic example, which has a high success rate in rehabilitation. It has a tough policy: a person has to take the rehabilitation course immediately they have been tested and found to have been taking drugs or they face criminal penalties. The rehabilitation course starts the following day. It is a residential course that can take months and includes mentoring back into the community. It is expensive, but Sweden's addiction rates are far lower and, as a result, its crime rate is far lower, too.

Charles Clarke: That is a helpful intervention. I agree with the description that the right hon. Gentleman gives of the Swedish approach, which does give people the hard choice that he describes. I agree that that is where we want to be. Why are we not there yet? It is because we cannot immediately make available a course of treatment or rehabilitation—whatever we call it—but, as I said to my hon. Friend the Member for Stoke-on-Trent, North (Ms Walley) a moment ago, we are committed to reaching that point. We have made significant progress.
	The question about the most appropriate form of rehabilitation, treatment or therapy—I use those words in different ways—is important. Even before I started my present job, I was aware that many people had opinions about the success or failure of particular approaches to the problem. The only way to decide that is to call in top medical opinion and monitor what happens in various programmes. That is what we are doing to try to improve the quality of what is available. The core solution is the one that the right hon. Gentleman implied in his question—to ensure that the best solution, whatever it is, is available from day one, so that the choice he describes can be offered. In some parts of the country, we are close to that point, but we are not yet there across the country. Clause 8 is intended to enable us to provide what one might call the Swedish choice.

Brian Cotter: My constituency contains more than 10 per cent. of the drug rehab beds in the whole country. Will the Home Secretary personally consider a report that has just been produced by the police and other agencies in the area, because I think that he would find it helpful in addressing the issues before us? We have many concerns in Weston, with many people coming to the area from other parts of the country and, if I may, I shall send him a letter with details of that and the report. We are especially concerned about cracking down on unrecognised and unauthorised rehab centres that promise rehabilitation but do not necessarily provide the best programmes to achieve it. Will that also be investigated?

Charles Clarke: I look forward to receiving the letter and reading the report to which the hon. Gentleman refers. He illustrates the approach that I have described. It is important to examine the record of particular approaches in particular circumstances. That is what the National Treatment Agency and the professionals in the field are doing. I have just been told by the Under-Secretary of State, my hon. Friend the Member for Don Valley (Caroline Flint), that Sweden, when it reviewed the situation, decided not to proceed with some forms of treatment or therapy after such monitoring. Across the world, people are considering each stage of rehabilitation carefully. Our problem is that the treatment programme has not been strong enough, until recently, for us to say that any proper programme was on offer. Our first ambition was to reach the point at which options for treatment were available. We have reached that point, but our second ambition is to ensure that those options are universally available. As part of that, we need to monitor and review the treatment properly.

Paul Flynn: While my right hon. Friend considers the Swedish experience, which has seen a recent relatively large increase in drug use, will he also consider the Portuguese experience? In 2001, Portugal decriminalised all drugs, which meant an immediate drop in the number of prosecutions from 2,005 to fewer than 13 in the last year. Drug deaths have also halved and the number of AIDS cases—[Interruption.] This is more serious than the intervention by the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) because the number of deaths in Portugal has halved from 369 to 132. More people use the prescribing system, but the number using drugs has fallen.

Charles Clarke: My hon. Friend is well known for making that argument over many years and he is entitled to make it. It is self-evident that if something is decriminalised, there will be fewer prosecutions for it, so that does not tell us anything. The interesting question arises from the other points that he made. The short answer is that I will consider the Portuguese experience, as I will look at every option, but I do not believe that decriminalising drug abuse is the right approach. Indeed, it is the exact opposite of the right approach. As the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) said, the core issue is the relationship between the criminal justice system and proper treatment or rehabilitation. That is the approach that we need to take to resolve the situation, not least because nobody should minimise the massive impact of drug abusers and their behaviour on the civil liberties of regular citizens. It is our obligation to address that.

Michael Clapham: The National Treatment Agency has suggested that the drop-out rate is due more to the procedures in clinics than anything that is wrong with the clients. It is clear that we need to spread best practice through the system, and it is important that my right hon. Friend meets the Secretary of State for Health to decide how that can best be done.

Charles Clarke: My hon. Friend is right. We need to keep learning. For example, the user groups associated with some drug action teams can give genuine feedback on what approach made a difference. I do not pretend that there is a universal solution—a magic wand that can be waved to solve the problem for every individual. People develop drug abuse habits in various ways, and various means will be needed to tackle their problems. I am encouraged to see that we are beginning to make substantive progress, as the figures that I gave earlier suggest. That provides the basis for further progress in the future.

Brian Iddon: What would my right hon. Friend say to civil liberties groups such as Liberty that say that testing for class A drugs at arrest rather than at charge is setting a dangerous precedent? Does not that criminalise people de facto, ask Liberty and similar organisations?

Charles Clarke: With all respect to Liberty, I fundamentally disagree with that view—strongly so. We have to get drug abusers who come into contact with the criminal justice system into treatment—whether rehabilitation or whatever word we use—as rapidly as possible. That is the core. No one has a right to abuse drugs, especially when we see the consequences of that abuse in so many aspects of crime. I understand my hon. Friend's concerns; he is well intentioned and has been a clear campaigner on civil rights issues of that kind, but if the choice is between the civil rights of a drug abuser or of those who are abused by the drug abuser, I choose the civil rights of those who are abused by the drug abuser. That is what lies behind the orientation of the Bill, but my hon. Friend is right to raise that point.

John Bercow: The Home Secretary is being extremely generous in giving way. Further to the intervention of the hon. Member for Bolton, South-East (Dr. Iddon), I am strong on civil liberties but there is one important exception in relation to drugs. One of my constituents lost his daughter in a car crash in 1984. To this day, he and his wife believe that the guilty party was either high on drugs or influenced by copious consumption of alcohol. Under the law there was no right to take a test without consent. That strikes me as wrong. As a parent, my constituent has to live with uncertainty as to whether there was causality for the rest of his life. Does the Home Secretary plan to address that important matter in the Bill?

Charles Clarke: The hon. Gentleman's general point illustrates extremely clearly the point that I was trying to make earlier. We are looking into impairment tests in that regard. There are some difficulties in relation to consent for people in certain conditions with which I dealt previously as a Minister. The hon. Member for Tiverton and Honiton (Mrs. Browning) took up with vigour ways of dealing with those issues and we are looking at them in the way that the hon. Gentleman suggests.

Cheryl Gillan: I have been following the Home Secretary's arguments carefully as he sets out the Bill. I hope that he will turn his face against the legalisation of drugs, although he seems to have left a small opening for the hon. Member for Newport, West (Paul Flynn).
	Why does the Home Office put so much emphasis on harm reduction and treatment, but so little on abstinence and rehabilitation? Does the Home Secretary intend to reverse that balance and will he tell the House when he will be able to offer a rehabilitation place on demand to somebody who wants to get off drugs?

Charles Clarke: I have obviously been guilty of misstatement if there is any doubt in the hon. Lady's mind: I am wholly against, without qualification, legalising drugs. If I was unclear in what I said, I reiterate it clearly from the Dispatch Box.
	On the point of substance that the hon. Lady raised, abstinence is obviously the right way to proceed. I have seen some excellent work by abstinence-based groups with prisoners and others, which takes a positive course. I do not think that the various regimes should be based on tolerance of a certain level of drug abuse as acceptable but we have to listen to the advice of the professionals about the best way to proceed. I am certainly not such a professional, but we should look at the various ways of proceeding.
	On the hon. Lady's point about demand and that we should reach a state of affairs where a rehabilitation or treatment place is available at the outset—the point made by the right hon. Member for Chingford and Woodford Green earlier on—I am with her in principle, and that is the direction we are following. The path that we have set out is precisely drawn so that we can reach that stage.
	Clauses 9 to 19 deal with the police's power to require those who test positive for a class A drug to attend an initial assessment of their abuse. That will increase the engagement of drug misusers with treatment providers. At present, those who test positive are encouraged to attend assessment but only on a voluntary basis. The powers requiring such an assessment will enable the assessor to determine the level of dependency or the propensity to misuse the class A drug and whether the person might benefit from further assessment, treatment or both. The powers also provide for the police to require a person to attend a follow-up assessment to give a further opportunity to discuss their drug misuse with a drugs worker and to draw up a care plan setting out the assistance and treatment that the person needs.
	Clause 20 deals with antisocial behaviour orders and a new civil order—the intervention order—to be attached to an ASBO where the underlying causes of the antisocial behaviour relate to drug misuse. An ASBO sets out behaviour that the perpetrator is required not to engage in; the intervention order will set out activity that the perpetrator should engage in to address the causes of his antisocial behaviour.
	In that context, the Bill deals with so-called magic mushrooms. The chemicals inside them are class A drugs; the mushrooms themselves are class A drugs, if prepared or in the form of a product. The Bill will end uncertainty by making it clear that all magic mushrooms, in whatever form, are class A drugs, and will make it an offence, to import, export, produce, supply, possess or possess with intent to supply magic mushrooms in any form.

Jon Owen Jones: That part of the Bill deals with an anomalous position, but it also raises other anomalies. Can my right hon. Friend explain what harm currently done by the partially legal position of that drug will cease to be done or will be reduced by making it illegal? The drug grows widely naturally in this country and people could have it in their gardens without knowing it. Are they committing an offence? There is a hugely anomalous position on khat—a drug widely used by part of the community in my constituency; the drug is certainly harmful but it is entirely legal. The Bill does nothing about that drug yet magic mushrooms will be made more illegal than they are currently. What benefit will that bring?

Charles Clarke: We are looking in detail at the position on khat—

Paul Flynn: Oh no.

Charles Clarke: My hon. Friend is in despair at that proposal.
	We are addressing the status of magic mushrooms in particular because the chemicals inside them are class A drugs—they have an effect. As a result, people are preparing products using a brand of magic mushroom, and taking approaches designed to bypass the existing legislation, which is why we are addressing the matter in that way.

Paul Flynn: The Home Secretary is extremely generous in giving way. I want to be clear about the meaning of the provisions. He referred to the possession of magic mushrooms. I own a garden—as do the Queen and the Church of England. If magic mushrooms appear in those gardens, the Bill changes the law so that they become a class A drug for which people can be thrown into the slammer for seven years. Is my right hon. Friend really saying that we should treat the possession of a growing magic mushroom in the same way as we treat someone who owns a crack house?

Charles Clarke: Obviously my hon. Friend can pursue the issue in Committee if he wants to do so, but the fact is that there has been an increase of 400 per cent. in the number of outlets where those products are made available to the public and we have to deal with that, which is what the legislation will do.

Brian Iddon: Bearing in mind the fact that we declassified cannabis from class B to class C on the grounds of its harm, what evidence is there that psilocybe mushrooms are as harmful as heroin or either form of cocaine?

Charles Clarke: Again, we are in the hands of the experts, and the fact is that the hallucinogenic effects of the chemicals in the mushrooms are similar to those of LSD.

Pete Wishart: Does the Secretary of Secretary believe there is a case for increasing the bands used for the classification of drugs? Does he agree with the Runciman report and even the Home Affairs Committee, which say that classifying such drugs as class A exaggerates the dangers of magic mushrooms and ecstasy, while diminishing the dangers of heroin and cocaine? We have heard nothing at all about young people. Surely, we must make our drugs laws and classification credible to young people.

Charles Clarke: Let me be quite candid. There have been two or three interventions from Labour Members and from the Opposition that suggest a tolerance or understanding of people who use those drugs for their own pleasure, or whatever they do. I do not share that view in any respect whatsoever. It is crucial to deal with such drug use, which is what this measure does. Of course, when we look at the analysis of the banding classification system, it is appropriate and right to consider the advice of the professionals who make the medical assessment before coming to a view. That is precisely what we will do, but I do not share any of the apparent tolerance of those drugs that the hon. Member for North Tayside (Pete Wishart) appears to demonstrate. I may have misunderstood him, in which case I apologise, but that is certainly the impression that I have gained.

Jon Owen Jones: rose—

Iain Duncan Smith: I suggest that the Secretary of State look again at Sweden for one reason: it overcame the problem because it stopped classifying drugs in any way at all. Sweden just has one system: all drug use and abuse—the addiction—is prosecuted, which has had a huge result. Before the hon. Member for Cardiff, Central (Mr. Jones) tells the Secretary of State that there is a better way, I wish to make the point that Sweden did exactly what Portugal did and it was a total disaster, which is why Sweden has gone hard back on classifying drugs.

Charles Clarke: As always, I am grateful to the right hon. Gentleman for his advice, and I will look at the matters he has raised.

Jon Owen Jones: rose—

Charles Clarke: This is the final time that I will give way.

Jon Owen Jones: I thank the Secretary of State for giving way to me again, but the debate so far has focused on drugs without an attempt to classify or define what is meant by drugs, and the last intervention is a classic example of that. If we define something as illegal, it becomes illegal, but we never define why it is illegal. Drugs must become illegal where they do harm. If a drug is not doing harm or not doing sufficient harm, it should not become illegal. We use several drugs that are not illegal because society does not judge that they do sufficient harm to make them illegal. We cannot simply say that all drugs are what we say they are, without explaining why we say that they are illegal.

Charles Clarke: It is impossible to argue that the abuse of class A drugs, which is what we are principally talking about in the Bill, does not cause harm to society. [Interruption.] I am glad to hear that my hon. Friend is completely at one with me on that. I accept that we could discuss what should or should not come within the legal framework. My test has always been, and remains, whether a measure reduces the consumption of a drug, legal or illegal, since consuming less drugs is beneficial to society.

John Bercow: Fewer.

Charles Clarke: Fewer. I beg hon. Members' pardon; I stand corrected by the hon. Gentleman. [Interruption.] I am being correct again—perhaps we could have a discussion about that in Committee.

Paul Flynn: Will the Secretary of State give way?

Charles Clarke: I will not give way again; I have given way too much. In fact, I shall come to the conclusion of my speech.
	The Bill shows that the Government have consulted widely on the proposed measures. We have debated most of the provisions already in detail during the debate on the Loyal Address. I believe that the Bill is a measured and proportionate response to the problems that we face and that it will contribute to the Government's strategy to reduce the harm caused by class A drugs. The police have said that the measures will help them to tackle drugs. I commend the Bill to the House.

David Davis: Let me begin by telling the House that we welcome much of the Bill. Indeed, on the evidence of the last few interventions, I suspect that the Home Secretary's view is closer to mine than to those of some Labour Back Benchers.
	To pick out a few headline points, we welcome the extra police powers to test for class A drugs on arrest and the new measures to deal with those who conceal their drugs. Although the Home Secretary appeared to be concerned about civil liberties, he knows that I am probably tested most on them, but I agree with him entirely about this very important issue, about which Liberty is wrong and he is right.
	We are pleased that the Bill proposes a number of lesser measures, including making magic mushrooms a classified drug, although we are disappointed that the Bill does not include khat, which is already illegal in America, Canada, Norway and Sweden. I hope that we can discuss that in Committee. Khat is under investigation, and some Somali community leaders are concerned about it and would like it to become illegal.

Paul Flynn: rose—

David Davis: I will give way to the hon. Gentleman, but I shall limit the number of times that I give way because I shall have a limited voice today.

Paul Flynn: The certain result of criminalising khat and magic mushrooms will be, with khat, to drive a wedge between the police and the Somali and Yemeni communities in Britain, and, with both drugs, to create an illegal market. Their use will not go down; it will increase, as the use of all drugs increased when we introduced prohibition in this country in 1971, and it will do so in the hands of an irresponsible black market, and profits will be made. For example, we had 1,000 drug addicts in 1971, and harsh prohibition increased that figure to 280,000. Criminalisation is an extraordinary, foolish and self-defeating aim, especially with magic mushrooms. No one has ever been killed using them and they are non-addictive.

David Davis: The hon. Gentleman has a long-standing difference of view from most of the rest of the British population. That issue was best dealt with by my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith), when he pointed out that Sweden had tried the route that the hon. Gentleman advocates and it was a disastrous failure. Sweden's current approach has its vagaries, but it is much more successful.
	We welcome the Bill, but unfortunately it is only a small step in the right direction. It is not a solution to many of the problems that the Government have allowed to continue over the past seven years, but then no legislation can make up for the failure of policy that we have seen. The Government have had numerous initiatives, summits and crackdowns on drugs, but I am afraid that the result has been more drugs, more dealers, more crime and more violence. There are more than 4 million drug users in England and Wales, and more than 1 million class A drug users. Cocaine use is up 250 per cent. and ecstasy use has doubled.
	I agree with the Home Secretary that drugs wreck lives and that they are the scourge of society, and the Government should admit that they have failed to deal with some aspects of the problem. I was going to be quite hard about this, but frankly, given the Home Secretary's approach today, I am inclined to be more kindly, because he attacked the problem with an open mind. We will attempt to make the Bill as strong as we can in Committee. However, the problem is one not just for today—there are millions of users today—but for tomorrow.
	Drug abuse among the young is increasing. The Home Secretary cited some numbers that I shall dispute. In 2003, 21 per cent. of school children had taken drugs in the past year. In 1998, that figure was 11 per cent., according to Department of Health figures. Alarmingly, in 2003, almost two thirds of 15-year-olds had been offered drugs. Sadly, British teenage boys top the European league of cannabis users.
	I shall dwell on cannabis for a moment. Cannabis is not a harmless drug. Super-potent varieties have emerged in the past 20 years, and scientific evidence continues to show a heightened risk of mental illness for those who use cannabis regularly. A recent report suggested that someone who starts using cannabis at 15 has more than four times the risk of developing schizophrenia as someone who starts at 18. I quote:
	"It is undoubtedly the case that most users of class A drugs, such as heroin and cocaine, start off by using so-called soft drugs, normally cannabis".—[Official Report, 31 October 2000; Vol. 355, c. 430W.]
	The Home Secretary will recognise that quotation: he said it.

Henry Bellingham: Did my right hon. Friend see the report today that the Royal College of Physicians is very concerned about the new type of cannabis that can cause substantial brain damage and major problems in later life when it is taken by youngsters?

David Davis: I have not seen that report today, but it is the latest in a line of reports that have come out in the past 12 months that demonstrate that the perception of cannabis—primarily among the 1960s generation, like me, I guess—as a relatively harmless, recreational drug is very far off the mark. In fact, it is a dangerous psychotropic drug that does a great deal of harm, often in the long-term when it causes serious psychotic illness. That view will be reinforced by the report that my hon. Friend mentions.

Jon Owen Jones: The right hon. Gentleman is citing examples from different countries and times. Has he read that the prohibition of alcohol in the United States not only more than doubled the number of murders in that country and made the mafia extremely wealthy but changed the pattern of alcohol consumption? It was safer to transport potent alcohol, so the use of spirits increased enormously and the extent of beer drinking went down. Is there not a lesson to be learned from that example about more potent forms of cannabis?

David Davis: No, I do not think that that is the driving force. I am afraid it is a question not of reducing the volumes that must be carried but of what sells better. I understand the view taken by liberalisers, which is based almost entirely on the experience of prohibition, but I just think that it is plain wrong. These drugs do enormous harm, which is why the vast majority of the world does not believe in allowing them to be freely trafficked. We are part of the general consensus on that, so the real point to address is how well we control drugs, on which I shall take the Government to task in a moment. One of the problems with the Bill is that it will not tackle the users of soft drugs until they graduate to harder stuff.

Paul Flynn: Will the right hon. Gentleman give way?

David Davis: Not for a moment. I have only a limited voice left. The drugs that I am taking are legal, but they do not save it from wearing out quickly with this flu. [Interruption.] Magic mushrooms will not help either. [Hon. Members: "How do you know?"] I am sure that I take the Home Secretary's advice.
	By the time a drug user gets to hard drugs, it is often too late. Breaking a heroin habit is harder than breaking a cannabis habit. It is not surprising that drug use has gone up. Drug prices have fallen because supply has increased—it is as simple as that. Our porous borders have made it all too easy to smuggle drugs. It is estimated that seizures account for only about 10 per cent. of the drugs coming into the country, and I note that class A seizures went down a couple of years ago for the first time in memory.
	The Government have failed in their international responsibility to deal with Afghan opium production. Last October's bumper crop will flood our streets with heroin. With so many drugs available, it is no wonder that heroin has more than halved in price since 1995. Crack can be bought for a tenner in some parts of the country and ecstasy for a pound. At £1.95, a line of coke costs little more than a bottle of coke. Cocaine was once a so-called society drug that was available only to the rich, but now it can be bought with pocket money. Occasional users turn into regular users—users who demand a fix whatever the price.
	All too often, the cost of such dependency is crime, which is one respect in which I agree with the hon. Members for Cardiff, Central (Mr. Jones) and for Newport, West (Paul Flynn). Drug-related offences have risen by a quarter in the past three years alone. A heroin or crack addiction can be expensive, and it is estimated that a regular user spends nearly £450 a month on his habit. The Government admit that 70 per cent. of acquisitive crime is drug-related. About three quarters of hard drug users commit crime to obtain drugs, and persistent drug misusing offenders commit almost 10 times as many crimes as people who do not use drugs at all. It was reported last week that a £20,000 kilo of heroin would lead to 220 burglaries by addicts who need to pay for their fix. As of the end of last year, one acquisitive crime—shoplifting—has become punishable by fixed penalty notice. For a regular shoplifter, an £80 fine is less of a deterrent than an occupational expense.
	Unfortunately, drug crime is not only shoplifting but high-level organised crime that is often violent and gun-toting. With the drugs trade come drug gangs, drug barons, drug territories and drug wars. The lure of easy money can be too hard to resist. The gross margin from production to retail on a single gram of crack cocaine is nearly £50, so is it any surprise that burglars and other criminals are abandoning their old trade to sell drugs in the dark street corners of our cities and towns?

Nigel Evans: My right hon. Friend has already stated that some class A drugs are cheaper than a cup of coffee from Starbucks, which is clearly wrong. Does he believe that the Bill is deficient on the specific matter of sentencing and that those who deal in class A drugs should face stiffer penalties, as provided for by my private Member's Bill?

David Davis: My hon. Friend will get a roll of honour later in my speech.
	The Bill provides for the supply of drugs to children near a school to be considered as an aggravating factor for sentencing. The hon. Member for Bassetlaw (John Mann) made an intervention on the Home Secretary about that point. One is tempted to ask why that provision should be limited to schools rather than including youth clubs, skate parks, arcades and bowling alleys. Why should the provision not be extended to supplying children—full stop? We need to make it clear that dealing to children, wherever they may be, is an evil that will not be tolerated by this Government or any other Government of this country.

Angela Watkinson: I am grateful to my right hon. Friend for giving way—he can rest his voice for a moment. The Home Office "Frank" website gives the following advice on cannabis:
	"Smoking a spliff makes most people happy, relaxed and at peace with the world but the effects vary from person to person. Some people have one puff and feel sick. Others get the giggles until the muscles in their face hurt . . . Cannabis is quite an introspective drug. Once stoned, users can find hidden depths in daytime television"
	and
	"the most unlikely song lyrics".
	Does he think that that advice will encourage or deter cannabis use?

David Davis: The prospect of finding hidden depths in daytime television would terrify me, but my hon. Friend raises a significant point. There is a danger that the approach on harm reduction might encourage the use of drugs, or at least give out a neutral message. I—like the Home Secretary, to be fair to him—believe that drugs are unmitigably harmful and thus should not be encouraged in any way.
	I return to my point about penalties and supply to children. The Bill refers to cash payment for drugs that are sold to and couriered by children. I understand that youngsters in some cities are paid up to £30 a day to deliver drugs to users, but the Home Secretary should know that cash is no longer the only commodity traded for drugs. DVDs, CDs, computer games, trainers and mobile phones are today's traded goods for drugs, so people do not receive only the bankers drafts, cheques, notes and coins to which the Bill refers. I hope that we can pick up on that in Committee and ensure that the Bill's wording does not provide a loophole so that an expensive lawyer can get a drug dealer off.

John Bercow: My right hon. Friend's position on drugs is much clearer than that of the late Congressman Schwegel, the representative of Iowa, on whisky. When asked about that subject, he said:
	"If, when you say 'whisky', you mean the devil's brew, the poison scourge, the bloody monster that defiles innocence, dethrones reason, destroys the home, creates misery and poverty, literally takes bread out of the mouths of little children; if you mean the evil drink that topples Christian men and women from the pinnacles of righteous, gracious living into the bottomless pit of degradation and despair, shame, helplessness and hopelessness—then certainly I am against it with all my power. But if, when you say 'whisky', you mean the oil of conversation, the philosophic wine, the ale that is consumed when good fellows get together, that puts a song in their hearts, laughter on their lips and the warm glow of contentment in their eyes . . . if you mean the drink the same which pours into our treasuries untold millions of dollars to provide tender care for our little crippled children, our blind, our deaf, our dumb, our aged and infirm, and allows us to build highways, hospitals and schools—then certainly, I am in favour of it. This is my view and I will not compromise."

Hon. Members: More!

Mr. Speaker: Order. The hon. Gentleman would have been better to quote Robert Burns as saying:
	"Freedom and whisky gang thegither".

David Davis: If I may say so, Mr. Speaker, you are the last person I would have expected to quote that.
	My hon. Friend the Member for Ribble Valley (Mr. Evans) has published a private Member's Bill—

Jon Owen Jones: Before the right hon. Gentleman leaves whisky—

David Davis: No. The Bill is not about whisky. I may mention whisky later and give the hon. Gentleman another chance, but I will not give way now.
	My hon. Friend the Member for Ribble Valley has published a private Member's Bill that will ensure that anyone who is caught dealing in drugs with children will receive a custodial sentence. His Bill will also set a mandatory sentence for repeat dealers. Will the Government support it? I am sure that he would not mind if they adopted his measures in their Bill. Will the Government, while they are at it, consider encouraging schools to follow the Abbey school example and begin random testing for drugs at schools?
	The Home Secretary, when he was Secretary of State for Education and Skills, I believe, started the enabling of that process, but it was a very cautious enabling. Reading the guidance almost made me afraid of the proposal. Will the Government provide the resources and support to make random testing at schools happen? It is clear that many parents are concerned about drugs—

Charles Clarke: The short answer is yes. The right hon. Gentleman is right to identify random drug testing in schools as a necessary weapon for head teachers who wish to use it. I do not think that it is accurate to say that we were less than fulsome about it. On the contrary, we positively encourage it, and I certainly did as Secretary of State for Education and Skills.

David Davis: I am pleased to hear that. If I remember—I am relying on my memory, which is probably not a good idea given that I am on cold drugs—extreme caution was advocated. I think that that was the phrase used. That is one aspect. In any event, we should look at the guidance.
	The second point is resource. There are drug-testing machines that schools would not be able easily to afford but it might well be worth while providing them to local education authorities. It is my party's policy that we would do that. It would be a good idea if the Government took that on board as a way of accelerating the process. Addiction among the young is the most pernicious ailment afflicting our society, but as the Home Secretary said, it can be beaten.
	When I spoke to the Americans this summer on this matter they told me that they were able to reduce addiction generally among teenagers by 11 per cent. in two years. As the addiction that they were talking about included alcohol, I will give way to the hon. Member for Cardiff, Central (Mr. Jones) on his point on whisky.

Jon Owen Jones: I thank the right hon. Gentleman—he has given way often—for giving way belatedly to me. Which would he regard as more harmful, a spliff or a bottle of whisky?

David Davis: A spliff, because of the effect on the psychological health of the person in the long term. Whisky is, of course, harmful when used immoderately. Beyond that, I shall rest on Mr. Speaker's advice on the matter.
	I return to the issue of the reduction of addiction among teenagers. The rather simple point—a blindingly obvious point in a way—that the Americans made to me when they were talking about the matter was that the key was simultaneous reduction of supply and demand. They made the very good point that if supply alone was reduced, price was increased, and that that encouraged more supply, so that did not work. If demand was reduced but not supply, the pushers looked for new markets, tried harder and pushed demand back up. Simultaneous reduction of the two is a key part of any Government's strategy. It may sound an obvious point, but it is not something that many Governments manage to achieve.
	As I have said, we welcome the testing of class A drugs on arrest. As I understand it, the Bill makes provision to do so only for those aged over 18. Given the increasing use of drugs by minors, why not extend the provision to those under 18? That seems to me to be self-evident. It is a point that would be worth picking up by the Minister today or in Committee.
	It is proposed in the Bill to extend the arrest referral scheme, making it compulsory for those testing positive to attend assessment. As far as I can see, it does not make it compulsory to undergo a complete treatment programme. It is important to complete that programme, because starting such a programme is not a solution—finishing it is. Again, the Bill appears to apply only to those over 18.
	For those testing positive, what sort of care plan do the Government have in mind? Under the current arrest referral scheme, the Government's research seems to show that 97 per cent. of those interviewed failed to make it into effective treatment. The Government's flagship treatment programme, the drug treatment and testing order, has only a 28 per cent. completion rate and an 80 per cent. reconviction rate. One Whitehall insider is quoted as saying that "breach is the norm" with DTTOs. The only way to break the link between drugs and crime is to adopt the policy outlined by my right hon. Friend the Member for Chingford and Woodford Green when he talked about Conservative policy offering residential rehabilitation or the criminal justice system, and that choice immediately, not after a wait, and not the halfway measure that appears to be proposed in the Bill.

John Mann: Will the right hon. Gentleman give way?

David Davis: I will in a moment.
	I understand that the Home Secretary has to sort out the resources. However, it began to sound, when he was speaking, as though he agreed with our strategy. I take that as a good sign.

Iain Duncan Smith: Will my right hon. Friend give way?

John Mann: Will the right hon. Gentleman give way?

David Davis: I will give way to my right hon. Friend first.

Iain Duncan Smith: My right hon. Friend is touching on the rehabilitation point. A few weeks ago I visited a centre in Norfolk—the Princess of Wales rehabilitation centre, I think. About a third of its beds were not occupied. The reason was the way in which the local authorities were involved in deciding how much money was allocated and whether people could be put into that rehab. Does my right hon. Friend agree that we need to put the power to put people into rehabilitation either in the hands of the courts, with the money to follow them, or in the hands of the police, or both, but certainly not leave it to local government or any other body, even including health departments, and that when someone is found to be on drugs the decision should almost immediately be made and the process begun?

David Davis: I agree for two reasons. First, for the immediacy of the decision, and secondly because the systems that work require some continuing coercion. They require the option, for example, of saying, "If you fail in this system, you are back into the criminal justice system." For both those reasons it is worth while doing exactly what my right hon. Friend says.
	I now give way to the hon. Member for Bassetlaw, who I know has a long record of interest in these matters.

John Mann: Will the right hon. Gentleman explain why, when his party voted for residential rehabilitation 18 months ago, it cited Sweden as the example? Will he explain also why Sweden reduced last year the number of places in residential rehabilitation by more than two thirds?

David Davis: Off the cuff, I cannot explain why Sweden did that. It was not just Sweden. As I have said, I talked to the Americans during the summer, and they were sceptical. I know that the hon. Gentleman is also sceptical of residential rehabilitation. There are other schemes that can work for some, but the predominant fact about residential rehabilitation, backed up by coercive measures, is that there is recognition of how difficult it is to get off drugs. What is proposed will have to be matched inside prisons.

Iain Duncan Smith: One of the answers about Sweden is the budget pressure that it has had. The argument in Sweden takes place on the basis of how much more the residential care programmes delivered, given the extra effort put in, than non-residential programmes, and whether it was worth the extra money.
	In the UK, I used to visit C-FAR in Devon, which worked with prison officers and the police. By taking people residentially, it has reduced reoffending among young offenders to under 40 per cent. in Devon as opposed to 73 per cent. nationwide.

David Davis: As my right hon. Friend speaks, the head of C-FAR is addressing a conference at Portcullis House on precisely that issue.

Paul Flynn: Will the right hon. Gentleman give way?

John Mann: Will the right hon. Gentleman give way?

David Davis: No. Hon. Members can speak about these matters later in the debate if they want to do so.
	I move on to the Government's latest proposal in clause 20, which is the intervention order. The Bill states that a new order can be made alongside an antisocial behaviour order when drug misuse has been the cause of behaviour that led to the ASBO being made. Government statistics show that 25 per cent. of people experience drug-related incidents of antisocial behaviour. The explanatory notes say that there are 15 million incidents of antisocial behaviour each year. That could mean nearly 4 million acts of potentially drug-related antisocial behaviour every year.
	The Government's estimate is that only 100 of the new intervention orders will be issued each year. That means that about one in 40,000 drug-related antisocial behaviours will be picked up. Even if it is 5 per cent., it will be one in 7,000. That is hardly going to solve the problem. The explanatory notes state that the cost of 100 orders will be £370,000. With 1 million hard drug users in the country, that is 37p a piece or about £1.50 per problem user. However, given that the Government have agreed to delay the commencement of that provision until April 2006, it will be rather meaningless for the next 15 months. It may be a good idea, but as it stands it is an inadequate measure that will be introduced too slowly and too late. If it is to be introduced, it must be done properly and immediately. There are problems today as well as in a year's time, when another generation of children will get hooked on class A drugs.
	I am glad that the Government have not given up the war on drugs, but although we may not have lost it, we are not yet winning it. We will support the Bill today because it is a step in the right direction, albeit only a small one. The Bill does not reclassify cannabis, it does not require residential rehabilitation, and it does not encourage schools to test pupils. It does not set mandatory sentences for repeat drug dealers or provide for automatic custodial sentences for people dealing to children. The illusion of action is sometimes more dangerous than inaction. I hope that in Committee the Bill will be toughened up, and I am optimistic, following the Home Secretary's speech, that there will be tougher practical measures on drugs. So far, there has been a great deal of rhetoric but not enough action, and too many children are at risk in the country to allow that to go on any longer.

Paul Flynn: First, I wish to clear up the issue of what happened in Sweden. As a rapporteur for the Council of Europe, I produced a report on drugs policies in which I made comparisons between the two most prohibitionist countries in Europe and two with pragmatic policies. The report covered the period from 1900 to 1999, and it showed that areas with the harshest policies in Britain and Europe had the largest increases in drug use. I do not know whether the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) was updated on the position, but since 1995 there has been a fourfold increase in drug deaths in Sweden. A report by the Swedish Forensic Medicine Institute said that Sweden probably had the highest number of per capita drug deaths in Europe. I do not know whether the right hon. Gentleman received an explanation, but there are some very good propagandists for the policy.

Iain Duncan Smith: The hon. Gentleman is a fair man, so I am sure that he would like to correct those figures. He will recall that Sweden followed a programme of complete liberalisation in the 1970s and early 1980s, and the figures show that addiction levels went through the roof. Since the Swedes have taken a harder position, addiction has fallen dramatically. Yes, there have been some increases, but they are in line with other increases in the west following the advent of crack cocaine. That has changed things, but I suspect that the Swedes are better off now than they were with that liberal policy.

Paul Flynn: The right hon. Gentleman is right that there was an increase, as there was in Switzerland, after liberalisation, although that is not the case now. However, the picture over the past 40 years in Europe is clear: some forms of decriminalisation and free-for-alls are certainly not desirable and do not work. However, the sum of experience on our continent and elsewhere shows overwhelmingly that prohibition increases drug use. In this debate, we all share a common desire to reduce the consumption of every drug, because they are all dangerous. We must make decisions about their comparative danger, but as I said in an intervention, Portugal has recently achieved some interesting results in a short period. Italy, Belgium, Switzerland and Germany have also tried interesting experiments by setting aside areas in which people can use heroin in safe conditions rather than taking it in the street, as happens in this country. Such experiments clearly have significant health benefits.
	Decriminalisation was introduced in Portugal. People may treat that lightly, but some offences are still in place. Prosecutions went down from 2,500 to 13, which represents an enormous saving in time for the police, the courts and prisons. The drop in the number of deaths—the worst possible outcome of drug taking—has been most impressive. They have fallen from 369 in 1999 to 152 in 2003, and are still going down. There are fewer drug users with AIDS compared with non-drug users, and the percentage has declined in both real and relative terms. The number of drugs in use also went down in both absolute and relative terms. Decriminalisation has therefore been an unquestionable success in just four years.
	There is, however, a period of 25 years to study in the Netherlands, and I have spent a great deal of time looking at what has happened there. I always like to make the point that I have never used an illegal drug, and neither have I used many medicinal drugs in my entire life. I am very hostile to drugs and, having spent most of my working life as a chemist, am suspicious about the side effects of drugs, including many medicinal drugs. I do not want anyone to use any drug whatsoever if that can be avoided, but we must accept the reality of what is going on. The Bill is the most atrocious piece of populist, knee-jerk legislation in the House since the Dangerous Dogs Acts.
	There is no case for taking the approach to magic mushrooms adopted by the Bill. I have been in correspondence with the Under-Secretary of State for the Home Department, my hon. Friend the Member for Don Valley (Caroline Flint), about the position on magic mushrooms, but not in my wildest dreams did I believe that that would precipitate the measures in the Bill. The Government could have done three things. First, they could have left the law alone and not touched it, even though it is absurd and irrational. If hon. Members went down on their hands and knees and grazed on magic mushrooms as they grew, they would not be committing any offence whatever. If they picked the magic mushrooms and ate them, they almost certainly would not be committing an offence. If they picked them and left them overnight, they would be using a class A drug because there would be a change in the magic mushrooms. The present law cannot necessarily be defended, but it does no harm.
	One country has recently set up legal outlets for magic mushrooms, and that would have been a sensible way forward for the Government. Instead, however, they have made a laughable decision. The hallucinogenic effects of magic mushrooms are not serious, and are not as bad as some of the side effects of over-the-counter drugs that can be bought in chemists. No one has ever been poisoned or killed by taking magic mushrooms. The Government website points out that they are not addictive in any way. They are among the mildest drugs, whether legal or illegal, that are available. Unlike those great killers, alcohol and nicotine, magic mushrooms are an entirely innocent drug and the dangers involved are not comparable. There is a market for them, and I agree that it is growing a little—there were more at Glastonbury than there had ever been before, but that meant that there was not as much ecstasy, so there was a decline in the use of other drugs. If magic mushrooms replace the use of more dangerous drugs, so what? The idea of banning them and treating them as a class A drug on a par with heroin and cocaine is ludicrous. I hope that the Government will have second thoughts, because their action cannot be justified. As I suggested in an intervention, criminalisation will certainly increase their use, as that happens with all prohibition.

Laurence Robertson: I am following the hon. Gentleman's argument about the connection between prohibition and usage. By way of analogy, would he support a ban on smoking in public places, particularly pubs and restaurants?

Paul Flynn: Yes, I would, but I very much support the use of snus. Inveterate users of tobacco who cannot give up can take that Swedish drug, which has reduced cancer deaths among males from nicotine by 50 per cent. That is one of the most extraordinary health improvements in the world. Sweden is the only country to have reached World Health Organisation targets for the reduction in cancer deaths by 2000, and it did so by encouraging people to ingest nicotine rather than smoke it. As with cannabis, the danger comes from smoking. In this country, people mix cannabis with tobacco, a dreadfully toxic addictive drug that kills.
	To return to the point that I was making, one of the stronger arguments against prohibition is that in the Netherlands, after 25 years of regulated, controlled decriminalisation of cannabis, its use among all age groups is half the rate of use in this country, and it is often used in a way that avoids smoking—in a safer way, by being ingested in cakes or drinks, or in other ways.
	I see two stages to the campaign: first, we must get rid of prohibition—of course, we must increase treatment; and, secondly, we must campaign with a message that is credible and that will be believed by young people. The proposal before us will be greeted with nothing but derision by the country as a whole, especially by those who use magic mushrooms. I asked the Minister a question and did not receive an adequate reply, but I believe that if we designate the magic mushrooms growing wild in our gardens and elsewhere as a class A drug, we will all possess it and we will all be open to the charges. We cannot make nature illegal. Magic mushrooms are part of the natural world. Some might describe them as a gift from God.
	The Bill is an attempt by the Government to appear tough on drugs. I suggested some time ago that we could not read the manifesto of any party for the next election without coming across the word "drugs" and in the following sentence the word "tough". The Government have excelled themselves this time by ensuring that in the Home Office press release there are four "toughs" in 150 words. The clause is the News of the World clause. Like the campaign that was conducted by the tabloids on dangerous dogs, the News of the World has a campaign and the Government react. Dogs bark, children cry and politicians legislate. I urge the Government to stop taking the tabloids. They would do well to stop pandering to the lowest common denominator of public opinion.

Jon Owen Jones: My hon. Friend says the Government are pandering to public opinion, but I am not sure that is the case. Public opinion is not the same as the majority view expressed in Parliament. I recall one of the tabloid papers—The Sun—running a campaign against cannabis and inviting its readership to express their opinion. The readership overwhelmingly deplored the opinion of The Sun and said that cannabis should be made a legal substance.

Paul Flynn: I stand corrected. What I meant to say, and what I think I did say, was the lowest common denominator of public opinion. All the informed groups that have reported on drugs and all the committees that have met, including our own Home Affairs Committee, have urged reform along the lines that I support, rather than along the lines that the Government and the Opposition support. That is telling.
	I remember the day in 1998 when we set up the drugs tsar. There was unanimity among those on all the Front Benches, which is always a certain sign that the Government have got a policy wrong. Only one Member spoke against the drugs tsar with his preposterous posturing and his idiotic targets of reducing the use of some drugs by 25 per cent. and even some by 50 per cent. I was disappointed with the answer I received when I asked the Minister the difference between drug use now and in 1998. He gave one figure that related to 1998. Readers of Hansard will notice that all the other examples he gave had nothing at all to do with 1998. He mentioned a few years selectively.
	Since 1998—indeed, since 1971—there has been a huge increase in the use of drugs. It has been gradual, and occasionally the figures have gone down a little, but the overwhelming trend in use has been upwards and the trend in price has been downwards.

Nigel Evans: I thought Keith Hellawell was a very good drugs tsar. Sacking him sent all the wrong signals. That was the point at which the direction of Government policy on drugs such as cannabis went wayward. The hon. Gentleman's thesis is that if only we were to legalise drugs, the problem would go away. If the solution was as simple as that, it would have been done many years ago and in many countries. The fact that that has not happened disproves his case. We need to get the message out and send the right signals, particularly to young people, that the drugs that the hon. Gentleman wants to legalise and make freely available on the streets are killers.

Paul Flynn: The hon. Gentleman speaks as a seller of tobacco. Perhaps I could tell the House that he persistently invited me to visit a club in the west end of London with which he was acquainted in some way. People there greeted him with the words, "Hello, Nigel" and me with "Hello, Mr. Flynn". As members of the House of Commons drugs misuse group, we went to inspect the drug precautions in the club. We inspected every floor and every area of the club, we saw the cameras, and everything seemed to be entirely in order. People there were very pleasant to us and explained what a wonderful drug policy they had. A fortnight later came the news that that club had become the first one in Britain to be shut down because of the open and blatant sale of all illegal drugs. I think it was called "Home" in Leicester square. It was useful to gain from the experience of the hon. Gentleman and visit his club.

Nigel Evans: Not my club!

Paul Flynn: The hon. Gentleman was well known there. His fame must have gone before him.
	The Bill is another example of evidence-free legislation. All the organisations that have any merit have criticised the Bill. Drugscope, which represents more than 900 agencies, is highly critical, as is TurningPoint. Lord Victor Adebowale said:
	"We need to focus on making current treatment programmes more effective, not dreaming up new offences to shovel people into the system. Instead, we see both the Conservative and Labour parties in a pre-election pantomime trying to prove who's toughest on drugs."
	Absolutely right. Release said:
	"It is a matter of concern that some of the best and most creative elements of the government's drug strategy are becoming distorted by virtue of misguided attempts to placate populist criticisms to the effect that it is insufficiently 'tough on drugs'."
	Last week I attended the World Health Organisation's conference on mental illness as a representative of the Council of Europe. It was a ministerial conference and one of the main issues before us was a report from the European monitoring centre on drugs and drug abuse. The figures for what they call co-morbidity and we call the dual diagnosis were frightening. The report quoted 80 per cent. of people with serious psychiatric problems also having serious problems of drug dependency. There is also a problem with smoking. A huge percentage of the people in mental hospitals are smokers, a far greater proportion than among those who are not mentally ill.
	Over the years, unanimity among all parties in the House on a Government policy has meant that it has not worked. We accept the increase in the number of cases of rehabilitation and treatment. My hon. Friend the Member for Bassetlaw (John Mann) is an expert on the subject. Treatment usually means abstinence, and it is coerced abstinence, which is never very effective. If it is voluntary abstinence, there is a good chance of people coming off the drug, but there is a dreadful failure rate for those involved in drug treatment. It is no way of taking people outside the system.
	We should consider what every group has suggested. A report was prepared by the group that advises the Prime Minister, suggesting that we should take a different line. In a splendid report, the Home Affairs Committee suggested that we try at least one intelligent idea that has been used successfully throughout Europe: users rooms for people who are inveterate addicts and who have been on programmes of rehabilitation and assistance for a number of years. I visited one of those in Amsterdam, and it was dealing with 400 addicts. Those people were unlikely ever to get off drugs, but the programme allowed them to use drugs that were clean, of known strength, and under circumstances in which there is assistance in case of trouble afterwards. An IT programme is provided, and those involved publish their own newspaper and have support. Many of them go back into the world of work and are rehabilitated. There is even a home for geriatric heroin users in Amsterdam, which we do not have here. Sadly, our addicts tend to end up on the streets, taking heroin of unknown strength and purity in unhygienic conditions, with dirty needles, and they have a short life span.
	We used to have a system in this country, before the 1971 Act, in which those people who were addicted to heroin could get hold of it from the national health service. That was contained, it worked, and there were virtually no deaths. Many of the people involved became addicted during the first world war through the use of diamorphine in battlefield surgery. One woman who took heroin in that way was the author of the book, "National Velvet". She was taking a prodigious dose of heroin, and eventually died in her bed, at the age of 91.
	Under our current system of prohibition, however, addicts are unlikely to see a full life. It is not the drug that is killing them—that is not to suggest that it is not dangerous—but the drug laws passed by us in the House. We will place an increased burden on those with mental illness—we are doing it, and the decisions cannot be pushed off to anyone else. In many cases, people sincerely believe that prohibition is working, although I cannot understand why, given that it has been shown over and over that it is not, and that it makes matters worse. There is also an element of populism: we are unlikely to get a sensible change with an election in view. Sadly, an attempt to gain popular appeal is very much what lies behind the Bill.

Tom Harris: I apologise to my hon. Friend for not being in the Chamber to hear the beginning of his comments. He claims that prohibition has resulted in increased drug usage, yet the legalisation of alcohol has also led to a massive increase in alcohol consumption. Can he comment on that in relation to his analysis?

Paul Flynn: When alcohol was prohibited, the use of alcohol decreased, but people moved from drinking beers to drinking distilled spirit—moonshine—the alcohol content of which was difficult to control, and it was toxic in many cases. There was also an increase in drug deaths. The worst effect, however, was the creation of empires of crime, with the result that an illegal market supplied the product. That went on for 13 years and then came to an end. At the same time, around 1920, the drugs that are illegal now became illegal throughout the world. A right-wing evangelical group in America spread their message throughout the world. We did not prohibit alcohol, but we did prohibit cannabis, heroin and cocaine, all of which we used as medicines for years before that, which had been doing little harm. The use of those increased, and the people in America who were selling moonshine moved on to selling illegal chemical drugs.
	If any Government wanted perversely to cause problems, they would decide that khat, which was mentioned earlier, and magic mushrooms should become class A drugs. The results, as I mentioned in an intervention, are absolutely certain. I have a large Somali population in my community, and khat is undesirable. It is not on a par with many legal drugs. It is chewed, and has a certain effect whereby people end up with a headache in the morning. It is not hallucinogenic, but it is undesirable because people waste a lot of time doing it. Many of the elders in the Somali and Yemeni communities are opposed to its use. It has been used in the Yemeni community in Cardiff and the Somali community in my constituency for 100 years. If it is made illegal, as the Government hinted that it would be, along with magic mushrooms, the immediate effect will not be reduction in its use; instead, it will become attractive, as it will have the appeal of forbidden fruit. There will be illegal users, the price will go up, and the profits will go up. The Government will therefore give an incentive to an entirely new illegal market. It could move from being a minor drug used by very few people to one that is used as greatly as many other drugs.

Jon Owen Jones: Illegality does not destroy the market—I am surprised that the Tory Front Bench team does not understand the market—it still exists, and competition always exists within a market. In an illegal enterprise, the only way in which people can compete is to use violence against their competitors. Because they are in an illegal market, their competitors cannot go to the police for protection from the violence being used against them. A pattern of increasing violence therefore results. That is exactly what happened in America during prohibition, when the murder rate skyrocketed, and it is what is happening today in our inner cities, where crime is being fuelled by an illegal drugs market.

Paul Flynn: Another example of the unreality of our world is that we are signed up to a United Nations programme that is being run under the deluded battle cry, believe it or not, of "A drugs-free world, we can do it". It claims that it is "on target" to eliminate all coca, cannabis and opium cultivation by 2008, which is a delusion of Olympic proportions.
	We should consider what America has done with Colombia, as we are about to repeat the same process in Afghanistan—we are about to Colombia-ise that whole section of central Asia. In Colombia, for 30 years, America has been destroying the crops by spraying, wrecking the livelihood of people living on less than a dollar a day. That has not worked, and world consumption of coca and all drugs has increased. In Colombia, there has been a slight decrease in production, but that has been replaced by production in Bolivia and Peru. Colombia is in continual bloody chaos, with three armies fighting a civil war.

John Mann: Is not the history of Colombia that cocaine production only began there in 1975, that before that there was no Colombian cocaine production, and that cocaine production in Colombia was begun by both right-wing and left-wing extremist factions to fund their activities, rather than the other way round?

Paul Flynn: Coca, of course, has been cultivated for at least 1,000 years, and was used mainly by people in Bolivia as an appetite suppressant and to counter altitude sickness. They chewed it, and western man—it almost certainly was a man—discovered that if coca is taken without the process of chewing, thereby avoiding contact with saliva, it is a hallucinogenic drug. We are trying to solve the problems that we have on the streets of Birmingham, and which the Americans have on the streets of Chicago, by wrecking the economies and the peace of third-world countries.

Nigel Evans: Just over a year ago, I visited Colombia, where I met British police officers who were liaising with Colombian security forces to help them tackle the drug problem. Surely we should not give up and allow Colombia and other countries to grow cocaine and other drugs. We should examine other countries—the hon. Member for Newport, West (Paul Flynn) has mentioned Peru and Bolivia—and obtain the same sort of co-operation between them and countries that live under the scourge of drugs, such as the United Kingdom, the United States and others, to ensure that we spread the co-operation that we extend to Colombia.

Mr. Deputy Speaker: Order. We are moving away from the core of the Bill and into a discussion about Colombia, and we are in danger of repetition. May I say to hon. Members who want to catch my eye that ever-longer and more frequent interventions are not helping the cause?

Paul Flynn: The United States has led the world to believe that harsh prohibition by fighting and by spraying crops will somehow reduce the problem. My point is that prohibition increases the problem. The only way in which to collapse the illegal, irresponsible and criminal markets in this country and in most other countries is to replace them with legal, regulated and controlled markets. Nobody is asking for a free-for-all that would expose people with children or people with mental health problems to drug use.
	A legal market reduces the need for control. To a great extent, that is what has happened in Holland, which accounts for the success of its policies over 25 years. Drug use by children is not a problem in Holland. Policing is much easier if one allows balanced adults to make their own choices. We would not dream of prohibiting alcohol or tobacco, although they do a great deal more harm and are more toxic and addictive than other drugs.

Laurence Robertson: Drugs are illegal in this country, and they would have to be legalised if we were to end up where the hon. Gentleman wants us to end up. Legalisation would surely send out a message. We should learn the lesson from lowering the classification of cannabis, which sent out a message that confused young people, many of whom thought that cannabis had been legalised. This place is not only about passing laws, but about sending messages.

Paul Flynn: In the eyes of most of the population, cannabis is legal now. In practice, my local police force and most police forces treat cannabis as though it were a legal drug. They do not waste time arresting people and taking them to prison, and they certainly do not waste time dealing with people who take cannabis as a medicine. Young people have made their own decision, and public opinion is in advance of that in the House—we are behind. People see the use of cannabis in the same way as the use of tobacco or alcohol, both of which are undesirable.
	Members of Parliament are a group of people who have had no experience of drugs in our youth, except for certain Conservative and Labour Front Benchers. The Home Secretary has said that he used cannabis in his early life and the shadow Chancellor has also said that. That strengthens the argument that cannabis is the start of a slippery slope. If one starts on cannabis, one ends up on one or other of the Front Benches, which is marginally better than the gutter, I suppose.
	We should follow the policies that work. America should not be used as a model. In America, 2 million people, most of them young blacks, are in jail for soft drug use. When I entered this House, 40,000 people in Britain were in jail. Now 70,000 people are in jail, most of them for drug offences, which are no more dangerous than taking many other ordinary drugs.
	Now we have this awful knee-jerk legislation. I never thought that I would say this in the House, but I hope that the revising Chamber will have the good sense to sabotage, wreck and obstruct the Bill in any way possible. At least the House of Lords contains one ex-heroin addict, who can talk from a great deal of experience. The Front Benchers were reticent when they discussed the Bill. Turning magic mushrooms or khat into drugs that are treated in the same way as cocaine and heroin is a crime-creation measure, and we cannot go ahead with it.
	The market is chaotic and out of control. The vulnerable people who are hit hardest are those who have the dreadful misfortune to suffer from a psychiatric illness and to have a drug problem. They are more exposed to illegal pushers than they would be if they lived in a country in which drugs were decriminalised, because it would then be much easier to concentrate on their protection. We must seriously examine the harm caused by drugs, which includes an increasing number of deaths, and the increasing use of drugs by psychiatric patients. The buck stops here. All parties have made wrong decisions on the matter since 1971, and the result has been a vast increase in the abuse of all drugs.

Alistair Carmichael: It is a pleasure to follow the hon. Member for Newport, West (Paul Flynn), who made an interesting and thoughtful speech—I agreed with some parts of it and disagreed with others. I was particularly struck by his description of the Bill as one of the most dangerous, populist and knee-jerk Bills to come before the House since the Dangerous Dogs Act 1991. If he considers the content of the past few Queen's Speeches, he will realise that he is setting himself an exceptionally high standard.
	In all fairness, although the Bill is a good attempt, the Government have not quite managed it. It has more than a whiff of populism about it, and, as the hon. Member for Newport, West observed, the timing, coming as it does in the run-up to an expected general election, is no coincidence. That is unfortunate because, as other hon. Members have observed, drugs are one of the most serious and profound scourges to affect many of our communities. Although today's debate has been good and has ranged fairly widely, the communities that we serve deserve better.
	It is an established fact that the United Kingdom has one of the highest rates of illegal drug use in Europe. Some 4 million Britons report using illegal drugs in the past 12 months, and the crime associated with illegal drugs costs society £16 billion a year. No community is immune from drugs. Because of its geographical remoteness, my constituency is often seen as being somehow safe from some of the worst social ills faced by metropolitan communities. Although it is certainly true that we do not suffer the same problems to the same extent, in my constituency, and particularly in Shetland, a growing pattern of hard drug misuse is emerging. We have seen drugs deaths, which would have been unthinkable 10 or 15 years ago.
	Before I entered this House, I was a solicitor in criminal court practice working along the Moray coast and in Aberdeenshire. I have seen heroin take a grip on fishing communities such as Fraserburgh and Peterhead and the damage that it has done to them. Those areas have a strong sense of community, which should have afforded them some protection, but such is the strength of the threat that it has not done so.
	Unlike the Conservative party, Liberal Democrats do not oppose the Bill, but we can see room for improvement.

Michael Clapham: The hon. Gentleman says that the strength of the communities that he represents has been undermined by heroin. Has he asked his CDRP—crime and disorder reduction partnership—whether it has done any recent research in relation to the audit that it will carry out, and does it show that there has been a decrease in heroin use?

Alistair Carmichael: To be quite clear, I said that there was a growing hard drug misuse problem in my constituency. It would be overstating the case to say that we have yet been undermined in the same way as some of the other communities in which I worked previously but do not represent. Heroin may have reached Shetland, but as far as I am aware, CDRPs have not yet reached our shores, although we may have similar organisations. The police and other social agencies in my constituency tell me that they are increasingly concerned about the growing use of hard drugs, particularly heroin. We may be five or 10 years behind the rest of the country in this respect, perhaps because we are better able to stem the flow of drugs into the community because of the limited number of entry points into places such as Shetland and Orkney. That is an obvious geographical advantage.
	It is curious that much of the Serious Organised Crime and Police Bill does not deal with serious organised crime, yet clause 20 of this Bill amends the Serious Organised Crime and Police Bill. That gives rise to a little cynicism.
	The provisions in clause 1 seem acceptable on the face of it, although some scepticism was expressed by the Secretary of State's Back Benchers, who perhaps know more about the extent of the problem that clause 1 addresses. Certainly, aggravated supply was not a phenomenon that I came across in the years that I spent in prosecution and defence in criminal court practice. If we accept that there is a mischief, the manner in which the Government are dealing with it may not be as clever as it could be. The fact is that supplying in the vicinity of a school is already illegal, as is supplying anywhere. It is already illegal to use a courier, because they would be guilty of being concerned in supply under section 4(3)(b) of the Misuse of Drugs Act 1971. Why is the age limit of 18 stipulated for couriers? Why not 16? If the Government are to be consistent in their logic—although it is not necessarily to be commended—surely a 16-year-old school-leaver should be caught, as well as an 18-year-old.
	If the procurator fiscal or the Crown Prosecution Service are on the ball, all such information should be put before the court as things stand. We should not insert a new section into the 1971 Act to say that age is an aggravating factor without determining the extent to which the sentence is to be aggravated, as happens with bail offences in Scotland. If an offence is aggravated by being committed on bail, the sheriff or judge has to make clear the extent to which that aggravation is reflected in the sentence. That is a rather more sensible way in which to proceed.

Brian Iddon: Does the hon. Gentleman accept that whatever age limit we set, criminals will use even younger children? When I worked with Greater Manchester police on the police service parliamentary scheme, I found that children as young as 12 and 13 were conveying drugs around the Longsight and Moss Side areas of Manchester.

Alistair Carmichael: I fear that the hon. Gentleman is absolutely right and that that practice will arise. That reinforces my suspicion, further to the point made by the hon. Member for Newport, West, that the Bill owes more to window-dressing than to dealing with the problems that arise from drugs use associated with people of school age.
	I have a less friendly interpretation of clause 2. Clause 1 is unnecessary, but clause 2 is potentially very dangerous. The Minister will be aware that case law already says that where the court is satisfied that the quantity of drugs alone is such that it can draw an inference of intention to supply, a conviction can follow. The Home Secretary said that different quantities would be specified in relation to different drugs. That is true, but I hope that he accepts that there will also be differences between what constitutes a dealer quantity, so to speak, in different parts of the country. An amount that would be a dealer quantity in London might differ from what would be the case in Birmingham, Glasgow, Edinburgh or Aberdeen. We will have to find some means of pulling all those different levels together, probably to the lowest common denominator, into one statutory instrument—but for what purpose? It will not leave the prosecuting authorities in any better position than that which they are in at the moment.
	The danger is that a police officer who is inexperienced or not as well supervised as is desirable will find somebody in possession of an amount of drugs that is, say 2 or 3 g less than the prescribed level, and say, "We've not got enough for possession with intent to supply under section 5(3) of the 1971 Act, so we'll do them for simple possession under 5(2)." In that situation, the evidence will not be properly considered, even if it is possible to set the level in the way that the Government seem to anticipate.
	As for clauses 3 and 4, it is only right that we acknowledge the practical problems that the police and other investigating authorities face in relation to people ingesting drugs, and we should try to tackle that. However, I should like the Minister to assure the House that the provisions will be used fairly sparingly and will be genuinely limited to those who are suspected of dealing and trafficking, and that meaningful safeguards will be in place to ensure that they are not used against those who would at most face charges of possession, not supply. I am thinking back to my experience as a prosecutor of having police officers coming to seek warrant applications in relation to supply allegations although all that was eventually found was a very small amount that would at most support a simple possession charge.
	With regard to clause 3(5), which inserts new section 13A in the Police and Criminal Evidence Act 1984, I am uneasy about the court's right, in relation to a refusal to undergo an intimate search, to
	"draw such inferences from the refusal as appear proper".
	Presumably those would be adverse inferences. I am not sure what is meant by the form of words that the Government have chosen to use. I hope that where such an inference is drawn it will not be akin to a presumption of guilt. As the Minister will be aware, the Home Office's own statistical bulletin shows that there were positive results in only one in seven of those who were subjected to intimate searches in 2003–04.
	I am also uneasy about the right to hold people for up to 192 hours. Again, I want assurances from the Government that the provision would be used only when an X-ray or a scan shows that ingestion of some sort has taken place and some higher test than mere suspicion has been applied. If it has been established that a substance has been ingested, for example, a powdered substance in a condom is often mentioned, holding people until, one way or another, it is out—if I may put it that way—is sensible; otherwise, there is always a risk of the vessel that contains the powder bursting and the person in question suffering an overdose. I understand the force of the provision but I would like some reassurance about the guidance that will be given.
	We have concerns about the provision for testing for class A drugs on arrest rather than charge and believe that it could be open to misuse. However, we will go along with it for the moment and simply say that the proof of the pudding will be in the eating. We can judge it to be a success if it leads to a greater number of people who complete treatment. I hope that it might be used to develop arrest referral procedures. Although that is a voluntary scheme, it has great potential that has not yet been realised.
	We shall try to explore several issues in Committee. We want to examine the way in which the results of testing and arrest will be used and the guidance, especially for police. Could any evidence that is adduced be used in relation to further, unrelated charges? We would also like some examples of the guidance that will be given to the police to ensure that testing for class A drugs on arrest is not used arbitrarily or oppressively, in the way that is sometimes suggested that stop and search has been used.
	We broadly welcome intervention orders, for which clause 20 provides. In the spirit of co-operation that the Home Secretary mentioned, we are prepared to work with the Government to ensure that the orders can be made as easily workable as possible.
	Let me deal briefly with the so-called magic mushrooms, which clause 21 covers. We must accept that the current position is anomalous but I am worried about designating those substances as class A. It is unrealistic to suggest that they are on a par with heroin and crack cocaine. It is the sort of provision that brings the drugs laws and this place into disrepute because it lacks credibility in the outside world. It is an example of the need to reconsider the classification of proscribed drugs in the way in which Runciman outlined.
	There could also be legal difficulties about possession. A landowner who has substances growing on his land and knows about it fulfils the tests of knowledge and control that constitute possession under section 5(2) of the 1971 Act. If the Minister can provide an alternative explanation, I shall be interested to hear it. I wonder if the clause will prove to be the provision that puts into clink the remaining country landowners who have not already put themselves there by refusing to stop hunting.
	The Misuse of Drugs Act was passed in 1971. It is ironic that we tend to revisit road traffic legislation every 10 years, yet we have had 33 years during which the 1971 Act has been largely unrevised in anything other than a peripheral and piecemeal manner. A comprehensive overview and re-examination of misuse of drugs legislation is long overdue. It is profoundly regrettable that the Bill is not that comprehensive re-examination. On the basis that half a loaf is better than no bread, we will support the Bill but look for something more in the future.

John Mann: The Bill, although limited in scope, contains one provision that, slightly amended, would provide a tremendous opportunity to enhance drugs work throughout the country. I shall deal with that in some detail later.
	The underlying problem in our debates about drugs is that we talk about drugs in general rather than the different types. If we were discussing cancer care, hon. Members would talk about the range of such care. For example, the diagnosis and treatment of skin cancer cannot be equated with that of liver cancer. Nobody would contemplate not differentiating in a debate on funding and organising the health service to tackle the problems of cancer. We do not do that when we discuss drugs, yet there is a great range of different drugs. We discuss the treatment for heroin as if it is the same as that for cannabis, anabolic steroids or cocaine. The treatments are different—sometimes there is a crossover, but sometimes they are entirely different. That is one of the big weaknesses in our approach to drugs.
	Let me consider the specifics of the Bill. Clause 1 mentions the "vicinity of a school". When I conducted an inquiry in my constituency, 3,000 constituents wrote in and gave evidence at my instigation. More than 200 expressly made allegations about drug dealing outside the school gate. They were highly precise and they named individuals. That was a major cause of concern, especially for parents. It is obviously something that a Member of Parliament would pick up. I therefore methodically spoke to those people and found that they were wrong. Their thoughts were not wrong but they were wrong to suggest that there was evidence. They all had an anecdote but none had evidence.
	I went into schools on many occasions to discuss the issue with pupils, especially but not only sixth formers. I asked them about drugs in school, at the school gate and outside the school. It would be accurate to summarise their response as deriding my suggestions. A comment was often repeated: "Why do you think we'd be stupid enough to buy or sell drugs in or just outside school? If we want drugs, we know where to get them and we'll get them. These are the kind of places where we'll get them." Parties were especially mentioned, but also premises where drugs would be supplied from time to time and individuals who were known to possess specific types of drug.
	There was fairly widespread knowledge, especially in some schools, about who could supply drugs, and indeed who should be avoided. However, the idea that people would bring drugs into school or that dealers would wait at the school gate was laughed out of court. That was a great surprise to me, because although I did not believe that the problem could be tackled easily, I presumed that it could be highlighted and that something could be done about it. Only one incident could be found in police records, and it occurred significantly nearer my office than any school. Indeed, it was nowhere near a school gate. We need to consider what we mean by
	"the vicinity of a school",
	particularly in the light of the proposal from the hon. Member for Ribble Valley (Mr. Evans) about aggravation in relation to sale to a minor. Whether we refer to any changes as strengthening or altering the law is really a political point, but we should be more precise.
	We should not give a false impression to the population at large that drugs are a major problem in and around schools. My contention is that that is not the case. Drugs in the community are the problem, not drugs in schools. These measures give our schools a bad name, and if we do not analyse the real problems, the solutions that we as legislators introduce will be the wrong ones. I therefore strongly recommend that the Government reconsider not the principle of what they are trying to achieve but whether their proposals will in fact achieve it. I do not think that they will.
	My second point relates to drug testing, of which I am totally in favour. Indeed, I might go even further than the Government in this regard. Drug addicts, particularly heroin addicts, repeatedly say to me, "Test us, stop us, force us, coerce us into treatment." There is obviously no opposition from the general population to compulsory drug testing, but the drug-using population in my area also supports it. It could also be extended to drug users returning to work. The testing might need to be voluntary in those circumstances, but not necessarily. Large employers in my constituency who refuse to take people on who have a criminal record for theft—which nearly always relates to their having previously been a drug addict—would do so if drug testing were available to them.
	I am suggesting that there should be compulsory drug testing, and that people with a criminal record for theft or for drug addiction who apply for jobs should accept that as perfectly reasonable. What form should such a system take? There is an important opportunity for union negotiation in this regard. I am involved in discussing with certain unions the possibility of establishing a fair and appropriate system that would give people the chance of re-entry into the workplace.
	The testing proposed in the Bill is a separate issue. The provisions talk about class A drugs, but I want to ask the Minister why we should not include class B drugs—especially amphetamines—as well. The problems caused by amphetamines are as great as those caused by cocaine, crack cocaine and heroin. They do not cause the biggest problems here—indeed, they are quite a small problem in my area—but amphetamines are the major problematic drug in countries such as Australia.

John MacDougall: Glasgow council and Central Fife council have introduced a system of drug treatment and testing orders, which offer an alternative to imprisonment for people indulging in drugs. They are given the opportunity to rehabilitate rather than go through the judicial system. Does my hon. Friend agree that that would be of benefit?

John Mann: I commend that approach as more effective and more cost-effective to the taxpayer.
	To return to the classification of drugs, I believe that the whole range of amphetamines should be reclassified as class A. I would like, however, to suggest an even better system. There should be three classes of drugs. The first should contain those drugs that are legal but damage people's health, such as nicotine, alcohol and certain over-the-counter drugs. Such drugs are likely to cause damage to people's health but not to the rest of the community, although perhaps we could argue about alcohol in that regard.
	The second class of drug should include those illegal drugs that happen, conveniently, to be in class C at the moment. It should be made explicit, however, that they can damage people's health but taking them is unlikely to lead to anyone taking action that would damage other people. In my view, it was right to reclassify cannabis as a class C drug, although I come to this argument from a slightly different angle from the Government. Cannabis can cause significant damage to health but it does not lead to people behaving in a way that would cause damage to others.
	The third class of drug should contain those that we now call class A drugs—there would need to be some changes in the classification, involving the total removal of class B—which damage people's health and are likely to lead them take action that would damage the community. We know that people who take cocaine and crack cocaine regularly are likely to be more violent. We also know that people who are addicted to heroin are likely to steal to feed their addiction. Amphetamines fall into both the second and third categories, which is why I feel they should have a higher classification.
	Those should be the three categories of drugs: two containing illegal drugs, the third covering legal ones. Some of the non-debates that we have about cannabis—we seem to have an obsession with cannabis—could be conducted in a more constructive context if that were the basis of drugs classification, because that is the basis on which we police those drugs, and rightly so. It also ought to be the basis on which we resource action against them. The highest priority ought to be given to those drugs that will cause damage both to people's health and to the rest of the community.

Michael Clapham: I hear my hon. Friend's proposal for the three classifications. Will he accept, however, that a cannabis user who also drinks can present a real problem so far as antisocial behaviour is concerned? Part 4 of the Bill introduces the means of tackling such problems. In my community, cannabis dealers have been dealing to young people who have then gone out drinking. The drinking has fuelled antisocial behaviour and caused huge problems. We need to bear it in mind that there is a crossover point.

John Mann: I am no supporter of being weak on cannabis. It is a very dangerous drug in terms of the health ramifications involved in its use. I am not sure that it is the cannabis that is causing the antisocial behaviour in my hon. Friend's constituency, however—I have seen no evidence that it can do so—whereas excessive use of alcohol is clearly directly related to antisocial behaviour and other criminal activities. This is the only lack of logic in my argument. We could say that there should be two categories of legal drugs. The important point, however, relates to illegal drugs. We should place drugs that damage people's health in one category, and those that also make it likely that their user will cause damage to the community in another. That would allow us to have a much more effective debate and to take more effective action on drugs.
	My third point on the contents of the Bill is by far the most important. A slight amendment would give us the opportunity to revolutionise drugs treatment, particularly for users of heroin but also for users of other drugs such as amphetamines. My proposal relates to the definition of assessors and follow-up assessors. The biggest weakness in drug treatment in Britain is without question the vagueness of the assessment procedure. Unless the Government are proposing any changes in this regard—I do not see any in the Bill—an assessor or a follow-up assessor may come from any of a whole range of professions. A psychiatry student straight out of university could be asked to make an assessment of a person's drugs treatment, for example. That is my experience, and that, in my experience, is why so much drug treatment in this country does not work.
	The situation in my constituency is fascinating. Two areas are particularly unsuccessful when it comes to drug treatment. The figures are astronomically different. One small area, Worksop, is covered by Mansfield primary care trust, which does not regard drug treatment as its responsibility—it believes that primary care should not be taking the lead. The same applies, incidentally, to all other Members' local PCTs. As far as I know, the only PCT in Britain that takes a lead is Bassetlaw. My constituents in Worksop with drug problems go and see, perhaps, a young psychiatry student just out of university, who tells them "You have a drug problem," and refers them on—and on, and on. Those who live in Bassetlaw go and see a GP. They do not see just any GP. They do not see the GPs people living in Worksop and Mansfield might eventually see—GPs who do not get jobs in practices when they apply for them. The GPs in Bassetlaw are highly professional, and people living there go and see them, unless they are subject to drug treatment and testing orders.
	If someone has a DTTO, a probation officer makes the decision. The only constituents in Bassetlaw who do not manage to see a GP for drug treatment are those with DTTOs. Some do, but not all do. A probation officer can look me in the eye and tell me what drug treatment should be given—what substitute drug should be prescribed, and what the dosage should be. That is the system that we have in Britain. That was the mess we had in Nottinghamshire, and still do in some parts of it. That, indeed, is the mess that we have in most of Britain.
	Were we to include in the Bill the modest proposal that the assessor could be the local GP—or, far better, should be, but I think the response would be that the health service is not quite ready for that—it would provide an opening to a drug treatment service that would work in most parts. Sweden has now moved away from residential rehabilitation, which is not particularly successful, and towards a GP-led service that is highly coercive. Someone caught with drugs in Sweden can be put straight into a secure unit—it is called a hospital—with locked doors. They will stay for five days, and when they come out their GPs will treat them. I would love to see that system operating in Britain. Sweden resources it very well.
	Although the Swedish system is not residential rehabilitation—one of the Opposition parties seemed confused about that—it is coercive, and it is compulsory. The parents of young people must accompany them to counselling sessions, and I think we could adopt that model as well. In my area, coercion is not the problem with DTTOs—quite the reverse: the problem is the treatment modality.
	Two years ago, only two people in my area were being treated by a GP. Today the figure is about 320. I do not have the precise figure, because it is rising daily. Virtually no one has dropped out: the drop-out rate is no more than 2 or 3 per cent. The figure has been rising for 18 months, so this is not a flash in the pan. Strangely, crime has fallen during the same period. The average number of burglaries in west Bassetlaw is down from 80 to 20 a day. I believe that that is the biggest fall in acquisitive crime in Britain. I stand to be corrected, but that is what the police tell me. The reason is simple: all the drug addicts who were doing all the thieving, burgling and shoplifting, or at least a significant proportion of them, are now having treatment.
	There are other benefits to the economy. Some of those people are returning to work, and instead of being benefit recipients they are becoming taxpayers. They are contributing to society. I think that that is a rather good definition of rehabilitation. People can go to their own GPs in their own communities. What is the first thing most of us do when we move house? We register with a GP. In a sense, that defines living in a community. It is wrong that a person's own GP should not be prepared to treat that person for an illness that is having an impact on the rest of the community. More than just medical treatment is needed from GPs: psychological treatment is important as well.
	All the evidence from Sweden, France and Australia suggests that when people go back to work, the vast majority no longer commit crimes and do not use the drugs that were causing them problems earlier. There are other benefits. Two years ago, 173 people were admitted to Bassetlaw hospital's accident and emergency department following drug overdoses; in the past 12 months, 39 have been admitted. The situation is much better for my constituents, who no longer see so many drug addicts clogging up the accident and emergency queue, and it means a phenomenal saving for the hospital.
	There is even better news about in-patient admissions for drug-related illnesses. Deep vein thrombosis is the main reason for a heroin addict to be admitted. Two years ago, at any one time two beds in Bassetlaw hospital would be occupied by drug addicts. Other patients stood a fairly good chance of having a drug addict in the bed next to them. That has been reduced by 400 per cent.
	There is a further saving to the health service. The hospital's main worry was that drug suppliers—friends of patients, rather than dealers—would go on to its premises to provide heroin or amphetamines for their friends. That is now a very small problem, because hardly any addicts are occupying hospital beds. The most startling development, although it is not one that most of the community is bothered about—it mainly concerns the mothers and families of addicts—is that whereas two years ago there were 11 overdose deaths, there has been none in the past 12 months. Those statistics are not mine—they are official, although that does not necessarily mean that they are undeniable. Because they mirror what has happened in France, Australia and Sweden, they should dictate what we do here, especially when it comes to treatment for heroin addiction.
	I recently met the prisons Minister, my hon. Friend the Member for Wythenshawe and Sale, East (Paul Goggins), who told me that the Prison Service was adopting essentially that approach. I am pleased about that, because it is the right approach, but it should be built into the Bill, because giving assessment duties to probation officers or drugs workers—whatever that means—constitutes a fundamental weakness. We should be methodically beginning to ensure that whatever treatment is provided is under the control of a person's GP. If a GP wants to refer someone for residential treatment for a week, a month or six months, that is excellent if it is appropriate for that person. If GPs want to involve specialist mental health care, as those in my area regularly do, they should be able to. The GP should be the pivotal point in the treatment. That is the big difference between us and countries that have been far more successful with drug treatment.
	Modest though the Bill is, with those slight amendments it could put real pressure on the health service to deliver. The levels of crime reduction and health improvement that we are seeing in my area could then spread to the rest of the country.

Nigel Evans: It is a pleasure to follow the hon. Member for Bassetlaw (John Mann), who has been interested in drugs policy for as long as I have known him. He has looked at best practice in a number of countries that he has visited, identifying where things are going right and where they are going wrong. We should all be looking for examples from around the world, although we may not be able to replicate them exactly because ours is a different society. Some countries can do things that we simply could not replicate here because our culture is somewhat different, but it is still important to take note of those countries that have got it right, and to see whether we can take the best of what they do and put it into practice.
	I agree that the Bill, which I shall certainly support, is modest, and we should try to improve it and strengthen it in Committee. This is an opportunity to see exactly what we can do to improve the quality of life of everybody in this country who is dogged by drugs in some way or other: those who are personally hooked on drugs and who want to get off them; the families who suffer as a result; and the wider community, which suffers because of the drug dependency of certain individuals. We need to tackle that problem and although the Bill is a step in the right direction, we can take some further tentative steps to ensure that it is more effective.
	I should clarify what the hon. Member for Newport, West (Paul Flynn) said about our visit to a club over a year ago.

Alistair Carmichael: Stop digging.

Nigel Evans: Indeed, and if Members can hear an echo reverberating, it is because I am at the bottom of the hole in question. As well as being a former chairman of the all-party group on drugs misuse, I am also a vice-chairman of the all-party music group, and it was in the latter capacity that I, along with the hon. Gentleman, was invited to that club. The hon. Gentleman made it sound as though I was a regular visitor, but that visit was the first for both of us. We were given a tour of the club and, as he said, we examined each of the several floors and the closed circuit television system, and considered the club's use of bouncers on the front door and the staff's general attentiveness. We were impressed by what the club was trying to do. Young people visit nightclubs and we want to make them safe environments for everybody. Although that club's policy—as shown to the hon. Gentleman and me, at least—was absolutely right, it clearly was not as effective as it should have been because, as he pointed out, it was closed down a couple of weeks later because of drug use and dealing on the premises. That does not alter the fact that all clubs have a duty to play a role in ensuring that their environments are safe for young people to enter, free from the scourge of drugs.
	The Bill arrives against the very worrying backdrop of the United Kingdom's now topping the European league table for cocaine abuse; indeed, in that regard we have reached a level similar to the United States. UK levels are twice the average of any other country in Europe, apart from Spain. That is not a record to be proud of. An extremely worrying reported add-on is that 5 to 7 per cent. of Britons aged 15 to 24—we should remember that age group—have used class A drugs recently, with the levels in towns and cities likely to be "substantially higher".
	On cannabis, the report in question says that English boys are more likely than other European teenagers to have smoked a joint, with 42 per cent. admitting that they have tried the drug. Some 42 per cent. of boys and 38 per cent. of girls aged 15 in England have tried cannabis at least once. In Greece, Norway and Sweden—Sweden has been mentioned time and again, so we should probably go there to find out exactly what is going on—the corresponding figure is 10 per cent. England also has the highest proportion of heavy users, with 10 per cent. of 15 and 16-year-old boys having smoked cannabis more than 40 times in the last year. That is a hugely worrying statistic, and drug crime is of course on the rise. Indeed, there are an estimated 1 million users of class A drugs in this country.
	I agree with the hon. Member for Bassetlaw about schools. The picture is being painted of a school system completely riddled with drugs and drug abusers, but that certainly is not the case in my constituency. I am not saying that no instances of drug use have occurred during my 12 glorious years as Member of Parliament for Ribble Valley—of course they have—but the headmasters there have cracked down on the problem extremely well and have received great support from the local community in doing so. The problem does not exist in every school and classroom every day of the week, and we must ensure that that remains the case.
	I support the Bill's provision on drug dealing within the vicinity of a school. One young person abusing cannabis or class A drugs is one too many, and if we can prevent that from happening by stopping dealing within the vicinity of schools, or within schools themselves, that is what we must do. I was interested in what the Home Secretary said about possible funding of drug-testing equipment for schools. All school budgets are clearly somewhat constrained these days, so in areas where the problem is prevalent, schools might want to use such equipment, which they cannot afford to buy. I hope that schools that desperately need such equipment do not fail to get it for the want of resources.
	If such equipment is used and certain youngsters are found to have used class A drugs or cannabis, I hope that they will then get the counselling and attention that they need and deserve. As the hon. Member for Bassetlaw rightly said, such counselling should take place in the presence of parents. The parents will obviously be greatly worried and will want to take part in the counselling so that they can learn about the problems associated with drugs. Being parents does not make them know-alls about drugs; indeed, some are worryingly ignorant of what their children get up to.
	As the shadow Home Secretary said, the distinction is often made that cannabis is not a hard drug and has a "sixties" feel. However, this is 2005 and the cannabis generally available today is 10 to 20 times stronger than that available in the 1960s. It is a completely different drug. It is often regarded as being less harmful than class A drugs, but that distinction worries me. It is true that it is different, but a number of studies have pointed to the long-term effects of its use, particularly for those who start young. Indeed, I have just quoted statistics showing that a worryingly large number of young people are starting to use cannabis at a young age. Everything must be done to educate them and to get into the classrooms information on the damaging effects of cannabis and of class A drugs.
	Youngsters talk to each other, so they know whether dealing is going on in the vicinity of their school. I hope that they are encouraged to give that information to the head teacher, to Crimestoppers or to another known number, so that they can play their part in cracking down on the dealers, who should be behind bars, and in saving the lives of their friends. Those who get hooked on class A drugs, or on cannabis at the age of 14, face the prospect of death. Such an initiative would give some hope that the dealers can be taken out of the system, and that such youngsters might be given the chance, which comes only once at that age, that their lives can have some meaning.
	I cannot believe that the Bill has been criticised for being populist. What is wrong with populism? If introducing the measures in the Bill—along with some add-ons to stiffen it up—is popular in the country, what is wrong with that? What is wrong with ensuring that kids will not face drug dealers at the school gates, or be dealt drugs by a sixth-former? What is wrong with stopping the problem at source?

Alistair Carmichael: The hon. Gentleman is falling into the same populist trap. Such conduct is already illegal, and this provision is characteristic of much that the Government do, in that, in order to be seen to be doing something, they criminalise an already illegal act.

Nigel Evans: Clearly, dealing in drugs is illegal, but ensuring that it is viewed as aggravated if it is carried out in the vicinity of a school is absolutely right. We should send that message out repeatedly to drug dealers—that they will be dealt with in a much more severe fashion if they are caught. Also, if youngsters are being used as couriers, that must be stamped out as well. Drug dealers are some of the worst people in our society, and they will stoop to all sorts of tricks to ensure that their dirty trade continues. If they can get away with using kids to sell to kids, they will do it.
	I therefore support the Bill's provisions on dealing with drugs in the vicinity of schools. The Government know that my private Member's Bill is due on 25 February. I have been accused of being populist in respect of that, too, but I do not mind. My Bill is concerned with the people who deal drugs to youngsters. As the shadow Home Secretary mentioned, it is concerned not only with dealing in schools. For goodness' sake, young people go to a number of places, whether it be pop concerts, football grounds, youth clubs or whatever—they are all over the place. Frankly, anyone who deals to youngsters should be viewed as having committed an aggravated offence. That status should not be confined to those who deal within the vicinity of schools. I hope that we can look further into that in Committee to extend the red light to wherever young people are.
	My hon. Friend the Member for Buckingham (Mr. Bercow) made a compelling point about the drug testing of drivers, which is important when accidents have taken place. We should ensure that drug testing happens. Everyone knows about the dangers of drink-drivers, but the same applies to drugs. In 1984—I think that that was the date mentioned earlier—I am not sure that the methods for testing were as sophisticated as they are now, so let us look further into that matter in Committee.

Tim Loughton: Is my hon. Friend aware that, in some parts of the United States, offences caused by motorists subsequently found to be under the influence of drugs, particularly cannabis, outnumber the cases of drivers being under the influence of alcohol? Of course, drugs stay in the system for much longer than alcohol.

Nigel Evans: My hon. Friend is absolutely right. I believe that cannabis can stay in the blood system for about 30 days; the effects can certainly last longer. If that is what they are doing in the United States and it amounts to good practice, perhaps we should investigate further and find out what equipment they are using and how best to use it in this country. The United States is one of my favourite countries and the Americans know how to crack down hard on alcohol. Anyone going into a pub there has to be 21, demonstrating that the Americans know about the damaging effects of alcohol. Overall, when it comes to drugs in America, the percentage is about the same as in the United Kingdom. The US does not have such a great record on drugs as it does on alcohol.
	Searches are another aspect of the Bill. I sometimes feel uncomfortable about the issue. I am often as concerned about civil liberties as the next man, and I was amused by what my hon. Friend the Member for Buckingham said about whisky in that regard. Civil liberties are important, but so is people's ability to live their lives free of the scourge of drugs. I understand why intimate body searches of those accused of concealing class A drugs must be voluntary, and I therefore understand the Bill's caution in that respect. People also have to sign up to X-rays, but they do not seem to me to be the same as intimate body searches. I would have thought that anyone suspected of dealing in drugs should have an X-ray whether they like it or not. If there is good evidence to suggest that they are concealing class A drugs, they should be X-rayed. I understand that, later in the Bill, it is made clear that the courts can take a refusal to consent to an X-ray into account. Again, I would like to look further into the issue in Committee.
	On rehabilitation, which was mentioned by the hon. Member for Bassetlaw and others, we should reflect on what happens in Sweden, where GP-led rehabilitation takes place. That seems to be right for Sweden, but we do not yet know whether it is right for the UK. We do not know whether it would work in exactly the same way. What we do know is that there simply are not enough places for the people who need rehabilitation. I believe that we have only about 2,000 places, yet we need about 25,000.

John Mann: Over recent months, a whole series of rehabilitation places have closed. Voluntary places, under the brand name of "team challenge", have been shut down because there is not enough demand for them.

Nigel Evans: If someone is convicted of a class A drug offence and sent to prison, they should not just be left in prison for whatever the term of the sentence. We need to ensure that they can rehabilitate themselves while they are in prison. Sadly, we all know of cases where that has not happened, perhaps because of shortages in resources or in the number of trained personnel required for rehabilitation. The skills required are demanding and we need to ensure that we get the right people to help those who are hooked on drugs. Whether it is done under GP referral or in residential centres, it is crucial to get the right people to assist with treatment. If we are to crack down on drug dealers and give some hope to those who are hooked on drugs, we must ensure that the places are there in some form. I hope that the Government can assure us that that will happen. There is no point in convicting people if we cannot give them the assistance that they so greatly deserve.
	Prohibition has been mentioned repeatedly, but it is clearly not part of this particular Bill, as it represents tackling the problem from the opposite direction. If legalisation of drugs were the answer, I suspect that it would already have happened somewhere. It would have been seen to have been a great success and we would all be following the example. However, I suspect that the vast majority in the House and in the country believe what I believe: that if drugs are made more generally available, even through a legal system, more people will use them. My hon. Friend the Member for Tewkesbury (Mr. Robertson) referred to the signals that we send. One can only imagine the sort of signals that would be sent if we legalised or decriminalised the use of class A drugs. It would be a complete shambles. We have seen the effect of being softer on drugs in other countries and we do not need to repeat their mistakes.
	On the reclassification of cannabis, I refer to the Brixton experiment. The comments of many people, from police chiefs through vicars to mums, testify to the greater availability and use of cannabis in that area since that experiment started. Let us learn the lesson. Part of my private Member's Bill deals with the reclassification of cannabis. As I said, a number of reports have been published about the longer-term effects of cannabis. We should not put it on a pedestal and say that it is okay and that only dirty class A drugs are harmful. We need to tackle all drugs.
	When the former Home Secretary first appointed the drugs tsar, Keith Hellawell, I thought that it was a good decision. He brought out an annual report; we had an annual debate; and targets were set, if not always met. At least there was a focus of attention and a strategy. There seems to have been a blurring of late. We may not be able to go back to having a drugs tsar, but I hope that we can get back to having an annual report and setting targets.
	I hope that the Bill will be amended to make it stronger. Pressure can be exerted—from Conservative and Government Members and others—against drug dealers, whether they are dealing with class A drugs or cannabis. We should set targets to ensure that our policies are working effectively. We must aim to clean up our schools and the places where our young people go, so as to ensure that our communities are safer and free of the fear of crime fuelled by drugs.
	The Bill is a good start. It goes in the right direction, but I hope that discussion in Committee and in the other place will strengthen it and make it more effective.

Michael Clapham: I shall touch on three issues—the national scene and the rationale behind the Bill, the local drug scene in Barnsley, and finally the content of the Bill and ways in which it might be improved.
	I heard what was said by my friend the hon. Member for Ribble Valley (Mr. Evans) about Keith Hellawell, the former drugs tsar. However, the development of the Government's drug strategy since 1998 has brought good results, which my hon. Friend the Member for Bassetlaw (John Mann) described. I hope to illustrate that when I set out the improvements achieved in Barnsley through the application of various programmes within the framework of the Government's drugs strategy.
	This Bill will toughen the law to reinforce the fight against drugs in our communities. The organisations DrugScope and Training Point have some concerns about that, which I share. I hope that in Committee we will be able to concentrate on the points that those bodies have raised. In particular, I hope that treatment will be improved by taking on board what they have said.
	The renewed drive to tackle class A drugs has achieved good results in Barnsley already. I shall give some of the details later in my contribution, but that success has been achieved within the framework of the Government's strategy. There is still quite a long way to go, but there are signs that progress is being made and that there have been improvements throughout the community. That is why I support this Bill, although I believe that taking on board the suggestions of the two bodies to which I have referred will make it better.
	All hon. Members know that drugs cause misery. They fuel crime and antisocial behaviour, and the latter problem is dealt with by part 4 of the Bill. In my constituency, we had some problems about 18 months ago with young people who combined the consumption of softer drugs with drinking alcohol. That caused a real problem in the community, but we have tackled that problem locally and seem to have got on top of it. As I have said on many occasions in this House, the crime and disorder reduction partnerships offer a good mechanism for bringing together all the agencies in a locality to tackle crime and disorder.
	Some developments have been especially good. For example, our local primary care trusts work with wardens in the communities, and that has enabled us to tackle problems of antisocial behaviour caused by drug taking and fuelled by alcohol. Nevertheless, the cost of dealing with these problems is enormous. The hon. Member for Orkney and Shetland (Mr. Carmichael) put it at about £16 billion, but all sorts of figures are thrown around, with some estimates as high as £19 billion. I hope that my hon. Friend the Minister, when she winds up, will say what the real cost is. It is difficult to be accurate about such matters, as programmes run in each local authority area tend to overlap. It is also hard to estimate the cost of police and court time, and of the work done by the probation service, treatment centres and social services. Nevertheless, the amount of money involved is clearly enormous and must be between £16 billion and £19 billion.
	There is clear evidence that the Government strategy is beginning to work. It deserves to be supported, even if that means that we must bear a greater part of the cost. The Bill gives us an opportunity to come to grips with many of the problems in our communities.
	The link between drugs and crime is especially pertinent in my constituency, and in Barnsley as a whole. The local authority publicised a very interesting statistic after a survey was conducted in the mid-1990s. It stated that, in 1975, Barnsley was 15 per cent. below the national average when it came to crime but that, by 1994, the area was approaching 20 per cent. above that level.
	Two significant things happened in that period— the dislocation of the local economy as a result of the colliery closures, and the advent of drugs. Cannabis and heroin are the main drugs and they had become a real problem by the mid-1990s. There is no doubt that heroin had an impact on the statistics that I have just set out.
	On the national scene, it is evident that there is a relationship between drugs and crime. For example, the national England and Welsh drug abuse monitoring project—New Adam—conducted surveys and interviews involving 3,091 arrestees. The findings showed that 60 per cent. of them acknowledged a link between their drug use and their offending behaviour, and that there was a strong association between the use of heroin and cocaine and levels of acquisitive crime. Users of both heroin and crack cocaine reported that they needed an illegal income to pay for their drug use of about £24,000 a year on average.
	The same conditions apply to Barnsley. Much of the local research shows that users of cocaine and heroin resort to acquisitive crime to pay for their habit.

John Mann: Does my hon. Friend agree that the actual figure is far greater than £24,000? The figure of £24,000 represents the cash value of the stolen goods, not their actual value. If someone steals a computer worth £2,000 and sells it for £10, the difference is £1,990.

Michael Clapham: My hon. Friend makes his point clearly, and I agree with him. The research shows that the cost of drugs in terms of crime in our communities is considerable. To tackle crime effectively, we must tackle the drugs problem. On a positive note, a growing body of evidence suggests that if offenders receive advice and treatment at various stages in the criminal justice process, their drug use and drug-related offending can be reduced substantially. That is the rationale behind the Bill.
	In Barnsley, we have had a considerable heroin problem, which first became obvious in the early 1990s. A survey in 1997 by the drugs action team suggested that as many as 5,000 people in Barnsley regularly used heroin. However, that has changed since the Government's strategy began to come together in a more coherent framework. I shall refer to some of the results of the application in Barnsley of the Government's drug strategy.
	In order to obtain a fuller understanding of the drugs problem, and in readiness for the latest CDRP audit across the borough, the drugs action team commissioned the Barnsley drugs market mapping exercise, which was carried out by Sheffield Hallam university. The survey was done in 2004 and has provided some useful information. I have been surprised that the debate so far has made little reference to much of the work that the CDRPs have done, especially some of the research that they are doing as we move into the third phase of the CDRP audit system.
	The Barnsley survey made the point forcefully that drug misuse that is especially visible in disadvantaged areas is a significant problem in the area. We have several wards in the top 10 per cent. of deprived areas. Indeed, we have some of the most deprived areas in the country across the borough. However, the survey suggests that the drug misuse problem is not out of proportion to Barnsley's social and economic status. It also suggested that Barnsley has 1,500 problematic drug users. The term "problematic drug users" is not defined, but in 1997 Barnsley had 5,000 heroin users. I suggest that problematic drug users include those who regularly use heroin and are involved in acquisitive crime to pay for their habit. According to the survey, there were some 2,000 problematic drug users in 2000, but that has fallen to 1,500 in the latest survey.
	The main drug used is heroin, with a small group of crack cocaine users. There is also a strongly embedded cannabis culture across the borough and a growing powdered cocaine culture, which reflects the increased affluence of the clubbing population. As I have said, Barnsley has some of the most deprived wards in the country, but a great effort has been made by the local authority, with Government support, to renew the economy. Significant changes have been made.
	It is estimated that much of all crime is drug related, especially acquisitive crime such as domestic burglary, theft from vehicles and shoplifting. In common with research in other parts of the country, it appears that many problematic drug users acquire half of the income they use to pay for their drugs through low-level crime, including property crime, benefit fraud, drug dealing and prostitution. In fact, Barnsley does not have a significant sex trade, so that factor is different when making comparisons with the rest of the country; there are reasons for that, although I shall not go into them at the moment.
	The illegal drug economy of the town cannot be viewed in isolation. The research showed that a network links Barnsley and some other south Yorkshire towns to Sheffield, Leeds, Hull, Manchester, London, Liverpool and Nottingham. Heroin is established and widespread in Barnsley, although there is higher use in some communities; for example, the wards of Worsbrough, Athersley, Kendray, Thurnscoe and Goldthorpe all have higher heroin use and all are within the deprived 10 per cent. Most users go to a handful of regular dealers and most dealing appears to be small scale, although there is some evidence of established larger dealers who are usually paid in heroin.
	The Government's drug strategy has had a positive impact in Barnsley, and I noted from the contribution of my hon. Friend the Member for Bassetlaw that the same was true in his area. The change in trends has been significant, which increases my confidence that the Government's strategy is working, so the Bill will be helpful in ensuring that we make that change even more comprehensive. In Barnsley, the drug user profile shows that drug users tend to be older, in their mid-20s, and that fewer young people are attracted to the scene. That suggests that we have reached a plateau, at least over the period when the research was being carried out, and that fewer and fewer young people are coming on to the heroin scene, which must be good.
	More people are going through treatment programmes; for example, in 2003, 1,139 people went through treatment, while in the first three quarters of 2004, the number was 1,222, which suggests that when the report for the whole year is completed more than 1,600 people will have gone through such programmes.

Cheryl Gillan: The hon. Gentleman paints an optimistic picture of Barnsley, while admitting that there is still a significant drug problem in his constituency. Does he have statistics on how many of the people who went into treatment actually completed it and on the outcomes for those individuals?

Michael Clapham: No, not in the current statistics, but the Library research paper suggests that, largely, clients drop out because of the way the clinics work rather than because anything is wrong with the client, so we need to take on board through the Bill what has been said by organisations such as DrugScope and ensure that the available treatment is uniform across the piece, rather than showing the wide variations that my hon. Friend the Member for Bassetlaw mentioned. We need to drive forward best practice, because that will avoid the current high drop-out rate.

Cheryl Gillan: The hon. Gentleman is most generous in giving way again.
	I agree that best practice must guide our footsteps. I am not trying to catch him out in any way, but does he agree that it is important that we obtain verifiable statistics on the number of users who complete their treatment and follow them up even after that, the better to inform ourselves about which treatments are successful and which are the most positive outcomes? Sadly, at the moment either that information is being unwittingly concealed or no resources are available to obtain it. We would all benefit from such information and I shall be interested in the hon. Gentleman's comments.

Michael Clapham: I agree with the hon. Lady that we need to know the drop-out rate, so that we can address it. Certainly, I would have thought that all the crime and disorder reduction partnerships knew the drop-out rate. I will make inquiries and obtain the drop-out rate in Barnsley. Indeed, I will let her know the figure.
	More than 1,600 people had passed through treatment by the end of 2004. Importantly, acquisitive crime is down very significantly. Domestic burglary is down by 31 per cent. and thefts from vehicles by more than 20 per cent. As we put more people through treatment and as we deal with drug taking—in particular, heroin, which is a class A drug—we can see the benefits in the reduction in crime across Barnsley.
	In September last year, the criminal justice intervention programme and the prolific offender scheme went live. The ultimate aim of those programmes is to ensure that more offenders get access to treatment and are retained in treatment—the point that the hon. Member for Chesham and Amersham (Mrs. Gillan) made. The programmes will build on the work that is already going on in Barnsley and further improve the situation.
	We must all ask whether the Bill will assist—I believe that it will—but I said at the beginning of my contribution that I share some of the concerns of DrugScope and Turning Point. Moreover, there is some merit in the points that they make in their alternative Bill, and I am sure that my hon. Friend the Minister has seen some of those points. It is clear that, as we increase the number of people who undertake treatment, we need to ensure that fewer people drop out—again, the point that the hon. Lady made—as well as providing ongoing support.
	It is important that we can provide support in the community for people who have undertaken the treatment process. In that respect, I note that page 14 of the Library research paper states that there is evidence that those who are referred for treatment from the criminal justice system were 2.7 per cent more likely to drop out than those referred from other routes. It is important that we understand that point and that we better co-ordinate the pathways to treatment—again, something that my hon. Friend the Minister will consider to try to ensure that we have an improved treatment system that retains the people who are put into it.
	The same research paper suggests that a successful treatment outcome was related to the clinic at which the client received treatment, rather than to anything that was wrong with the client—a point that I made earlier. We need to ensure that such variation is overcome. We need to drive best practice throughout the treatment system. The National Treatment Agency for Substance Misuse has agreed to that point, and it is considering how it can make the treatment more effective. We therefore need to concentrate our efforts to speed up the treatment.
	It is essential that we get people into treatment as early as possible, which is why I support the Bill in its endeavour to ensure that people go from arrest and interview in custody suites to treatment. At the same time, we need to ensure that best practice is driven through the treatment centres in the system, and perhaps my hon. Friend the Minister will say, when she comes to the Dispatch Box, whether there are plans to do so in co-operation with the Department of Health.
	Last Friday, I visited Holden house, which is in my constituency. It is administered by the English Churches Housing Group and runs the supporting people programme, which was introduced in 2003. I am told that the programme had a budget of £1.8 billion when it started. However, the budget will be reduced over the next three years, which will threaten some of the short-term accommodation provided for young people, many of whom have mental health problems and have come through treatment to engage again with society. The programme is worth while and we should ensure that it is properly financed. The Office of the Deputy Prime Minister finances the programme, so will the Minister make it aware that there are worries that cutting the programme might well result in vulnerable young people being out on the streets? The programme is cost-effective when one bears in mind the fact that a vulnerable person out on the street is likely to be attracted back to the drug scene, which will result in increased police and court time and costs and NHS costs. The programme must be continued with an adequate budget.
	I support the Bill because it will contribute to the Government's drug strategy and help to make it more comprehensive. It will also help us to get more people into treatment. We need, however, to examine best practice and how we may speed up the process of getting people into treatment.

Laurence Robertson: It is a pleasure to follow the hon. Member for Barnsley, West and Penistone (Mr. Clapham), who made a comprehensive speech. My hon. Friend the Member for Ribble Valley (Mr. Evans), who spoke before the hon. Gentleman, is promoting a private Member's Bill on drugs. He was lucky enough to come second in the ballot and is putting his good fortune to use in probably the best way possible, given the problem that the country faces.
	Although I am sure that it was unintended, I got the impression from the Secretary of State's tone that he thought that the drugs problem was being beaten, but I submit that that is not the case. I support the Bill because it is an attempt to achieve that. Although I cannot demonstrate the deep knowledge of the matter that many hon. Members have shown, I want to speak in the debate because we are not beating the drugs problem.
	As my right hon. Friend the Member for Haltemprice and Howden (David Davis) said, the Bill is a step in the right direction, but only a small one. I regret to say that it is an attempt to correct the damage caused by the Government—perhaps inadvertently—when they lowered the classification of cannabis. I will make no apology for returning to that point on many occasions. The House does not only pass legislation. After all, legislation can only do so much, so we must send messages. Lowering the classification of cannabis got far more publicity throughout the country than the Bill will receive.
	As I said during an intervention, I recently heard that many young people think that cannabis has been legalised. One or two Labour Members said that the police are not bothering to arrest people for cannabis crime. Let us add those two things together: if young people think that using cannabis is legal and the police are not bothering to make arrests, why should young people not take cannabis? The Government are giving the message that drugs are bad, yet that taking the so-called recreational drug cannabis is not as bad as it used to be. We cannot tackle the drugs problem seriously when we give such mixed and misleading messages.
	My hon. Friend the Member for Ribble Valley referred to the Brixton experience. A pilot study was carried out, but because it did not produce the results that the Government wanted, the lessons drawn from it have been forgotten. The Government hired a drugs tsar, and because he did not say the things that the Government wanted to hear, he was moved quickly to one side. That is not the way to tackle the problem of drugs.
	There are good messages in the Bill and although it contains some good measures that are too strong for one or two Labour Members to take on board or agree with, such messages and measures are pointing in the right direction. However, the messages about drugs are rather weak when we compare them to some of the other messages that we send out from this place. For example, we are rightly deeply concerned about binge drinking, but we seem to hear much more about the problems associated with binge drinking—I accept that they are considerable—than about the problems associated with drugs.
	I return to my point that the message about drugs is not consistent and is not strong enough. Potentially, we are turning smokers into criminals, if the Government are returned. It seems that those who have a social drink or a social smoke are being treated like pariahs, yet drug takers are having far more tolerance extended to them. Sympathy they need, and I entirely support the calls, especially those made by my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith), for better rehabilitation, but the message about the evils of drugs, including the evils of cannabis and the psychological difficulties caused by cannabis, must be advanced with greater strength.
	We have heard arguments for the legalisation or decriminalisation, whichever term we use, of drugs, especially from the hon. Member for Newport, West (Paul Flynn), who made a thought-provoking speech. He demonstrated great knowledge but I disagree with the conclusions that he drew from the extensive studies that he has obviously undertaken. He said that if an activity is illegal, it arouses curiosity, especially in the minds of the young. I suppose that that is true. I suppose that many young people are curious about what it is like to purchase alcohol if they are not 18, but I did not hear the hon. Gentleman suggesting that we should legalise the purchasing of alcohol by those who are under 18. I do not think that we can follow the logic of the hon. Gentleman's argument in terms of what happened during prohibition. When I challenged him on whether he would ban smoking in public places, he said that he would. However, that sends out an inconsistent message.
	The hon. Gentleman almost suggested—I am sorry that he is not in his place to hear what I am saying—that the fact that it is illegal to possess and to take drugs made the committing of crime more prevalent. I do not follow that logic. The crime is committed to secure the money. If drug taking were legal, given their cost and their effects, many people would continue to commit crime to fund their habit. On that basis there is no logical or consistent argument.
	Drug taking or drug possession must be illegal if there is to be legal consistency. The taking of drugs fuels crime and crime fuels the taking of drugs, not only crime such as burglary or theft—those are the obvious two crimes—but, as the hon. Member for Barnsley, West and Penistone said, prostitution. When prostitution is fuelled by drug taking, further problems ensue, such as the trafficking of young girls. The result is a terrible vicious circle. The outcome is also higher rates of other crime. In Northern Ireland, where I happen to spend a little time and carry out studies, the drugs trade is an industry in itself.
	I cannot follow the logic of the argument that the problems would be removed if we legalised drug taking. If the crime that fuels the drugs is illegal, the drugs themselves should be illegal. As I pointed out in an intervention, if drugs are to become acceptable we would have to decriminalise them and make them legal. That process would send the wrong message. Are people who propose that drugs should be legalised suggesting that they should be sold alongside the Mars bars in the shop of my hon. Friend the Member for Ribble Valley? That would not be appropriate, but where would people obtain drugs if they were made legal? I believe that they would probably obtain them at the same places that they obtain them now. They would buy them from dealers, but cannabis dealers, I am afraid, also deal in stronger drugs. They do not just deal in what are sometimes erroneously termed soft drugs. Where will young people be advised to buy drugs if they are made legal?
	People take drugs for different reasons. Some turn to crime to fund their habit, but others may be considered the silent victims, and are members of the working population, the middle classes—whatever that means these days—and even higher classes. I telephoned Gloucestershire constabulary for advice on my speech this morning and asked how many such people take drugs. They said that, by definition, they did not know, because those people do not break other laws or steal to finance their habit. People who take drugs who then commit crime are the visible drug takers who are in the public eye but, worryingly, there are others we do not know about.
	The Bill that my hon. Friend the Member for Ribble Valley has introduced is rightly concerned with drug dealers, although it also calls for a full survey of the evils of cannabis. I am advised that if the police take out a drug dealer and he goes to prison—I am not suggesting that that should not happen—another drug dealer steps into his place and continues the supply of drugs. In other words, the demand side is probably the bigger problem. That does not mean that we should not hammer, for want of a better word, drug dealers, but a more imaginative approach is needed to stem demand as well as supply. Stemming supply might reduce usage but it might increase the cost of drugs, which could have a knock-on effect on crime, which would increase as people tried to pay for those drugs. The solution to that problem is extremely difficult, and I shall return to it in a moment.
	The law, as I have said, must crack down on dealers, and the police are using the Proceeds of Crime Act 2002 to do that. They say that it is helpful to be able to seize the assets of people who have been sent to prison for drug dealing because the police do not believe that prison is enough. Drug dealers, like many habitual criminals, regard prison as an occupational hazard. The police therefore find it useful to confiscate assets so that when those people come out of prison they cannot easily return to their evil trade. On the other hand, the police say that reducing those people to nothing may mean that when they leave prison, they are tempted to return to crime to get started in the drugs trade again. I do not know the answer to that problem—I am simply trying to highlight it.
	The supply of drugs is highly organised and suppliers deal in all kinds of drugs. Indeed, they deal in the drugs that they can get at that particular time in order to sell on. If they can get a shipload of one kind of drug at a decent price, they will buy that drug and move it on. As I said earlier, people who supply cannabis also supply many other drugs.
	Some aspects of the Bill are contentious. Testing on arrest does not seem much different from breathalysing somebody who is suspected of drink driving. If that helps the process, I do not see it as a problem. Another issue is the "reasonable" test when someone is caught in possession, to determine whether that person is a dealer, not just someone who takes drugs. "Reasonable" is probably the most important word in the English legal system, but it presents problems. What do we mean by reasonable? Is there any such thing as possessing a reasonable amount of drugs? I am not sure how the courts will determine that. The Committee may want to try to clarify the matter.
	The supplying of drugs must be tackled, as must the demand. More joined-up thinking is needed. Before 1997, we heard how the Labour party would introduce joined-up government. We are still waiting for that, and nowhere more than in drugs policy. There must be a stronger link between education, health and the criminal process. We should not be afraid to teach young people about the evils of drugs, the damage they cause, the fact that they can be carcinogenic and addictive, and about how starting on cannabis often leads on to class A drugs. We should say that much more clearly than we do.

Stephen Pound: I do not want to be antagonistic, but does the hon. Gentleman have any empirical evidence whatever to support the thesis that milk drinking leads to whisky drinking, or that cannabis smoking leads to the injection of diamorphine hydrochloride?

Laurence Robertson: I am grateful to the hon. Gentleman for that friendly intervention. No, I cannot say that drinking milk leads one on to whisky, but I am advised by many police officers that most heroin addicts started on cannabis. I am not an expert on the subject, as I said at the beginning of my speech, so I am persuaded by the views of the many police officers to whom I have spoken, who work at the sharp end of the business.
	We must teach young people about the evils of drugs in terms of their cost and the health effects, and we must stress how stupid it is to take drugs. We cannot do that while reducing the classification of the so-called recreational drug. I have Front-Bench responsibilities on other days for the Consumer Credit Bill. I said on Second Reading of that Bill that legislation cannot cure all the ills, and I accept that that applies to this Bill as well. Much depends on education.
	We have a difficult situation in this country, and probably throughout the so-called developed world, where attitudes do not help to combat drugs. We hear a great deal about civil liberties, and I agree with the Secretary of State when he says that one man's civil liberties are another man's ruined life. I paraphrase, but that was his general message. We must work on the basis that we believe in the freedom of the individual under the rule of law. When it comes to drugs, we need such law.

Stephen Pound: Will the hon. Gentleman give way?

Laurence Robertson: I hope this will be an easier intervention than the last one.

Stephen Pound: The hon. Gentleman's prayers are answered. Would he be interested to know that I think that my right hon. Friend the Secretary of State was trying to present to the House Sir Isaiah Berlin's famous comment that liberty for the shark does not necessarily mean liberty for the minnow?

Laurence Robertson: The hon. Gentleman puts it far better than I could have put it, and far better than the Secretary of State put it, too, which is not surprising. He has been in the House an awful lot longer than I have, but I have been here long enough to know not to take him on in combat. I will not go further down that route.
	I want to re-emphasise my main points: we need a stronger law, and I will therefore support the Bill, which moves us in that direction. We need the right messages to be sent from Parliament about drugs, and we need better rehabilitation treatment, and as in so many other walks of life, better education.
	I want to conclude on the point with which I started: the drugs problem is not beaten, and I am not yet persuaded that, at the moment, we are beating it.

Brian Iddon: I welcome this Bill, for one reason: that we can debate drugs in the House today. After all, it is the third largest business in the world in terms of producing the raw materials, trafficking them to nearly every country in the world, and selling them illegally, in most countries in the world, to people who suffer as a result of the illicit drugs market.
	The hon. Member for Ribble Valley (Mr. Evans) is right that it was useful to have a drugs tsar, for one reason alone: it allowed us to have an annual report, which allowed us to have an annual debate. When we lost the drugs tsar, we lost the annual debate. Bearing in mind what I said about drugs being the third largest business in the world, I have always argued—I have raised this matter at business questions—that we ought to have an annual debate on what, after all, is one of the biggest social problems facing Britain today. We need to measure how our Executive, the Government, are getting on with the powers that we give them to tackle what is a vicious problem.
	I am glad that, today, the phrase "the war on drugs" has not been used all over the House. I hate that expression. In my estimation, we cannot have a war on drugs: what we must have is a war on the causes of the misuse of drugs. In my opinion, those causes are simple: poverty and social exclusion. The poor people of Colombia and Afghanistan are forced, because they have nothing else to grow and no infrastructure to transport it, to grow the raw materials that are exported to the west—coca in one case, and heroin in the other—and in any case, there is much greater profit in that. Certainly, those people are socially excluded and poor. When the drugs come over to a modern, westernised country such as Britain, it is largely the poor and socially excluded who suffer as a result of using the end product. It is ironic that a connection exists between one country and another in that way.
	Drug selling is the biggest pyramid selling racket in the world. Reference was made to the fact that someone can be taken out of the pyramid and another person pops in. That is the nature of pyramid selling—the profits in the pyramid are so great that it never collapses. Even Mr. Big at the top stays, and if he is taken out, another Mr. Big goes into the same pyramid, whether it is the Italian mafia or another organisation that trades drugs, such as the IRA. In my estimation, the only way to collapse the global drugs trade is to collapse those pyramids. Economically, the only way to collapse a global pyramid that is making fantastic profits is to collapse the profits, which can only be done by taking out the risk and all the enforcement action throughout the world.
	My views on decriminalisation have been expressed in the House previously. Prohibition will never win this war, if we want to call it that. I have always argued that we should move away from the enforcement end of the spectrum and towards the health end. Many of those who take drugs are sick people—we are talking about addicts.
	The hon. Member for Newport, West (Paul Flynn) mentioned that a recent report about dual diagnosis states that 80 per cent. of people who misuse drugs are also mentally ill. I am chairman of the drugs misuse all-party group, which is meeting right now. Four or five years ago, we conducted a survey on dual diagnosis, which estimated that 40 per cent. of people who misuse drugs are also mentally ill. I expect that the percentage has gone up because more people use drugs now, but 80 per cent. seems rather high. Whatever the figure, we should never forget that many people who misuse drugs are mentally ill. The scale on which we criminalise mentally ill people is perhaps wrong, although if you have committed a crime, you have committed crime, and we should take those aggravating circumstances into consideration.
	My hon. Friend the Member for Bassetlaw (John Mann) referred to the difficulties with treatment services, which still fail to recognise that they are often dealing with people who not only misuse drugs but are mentally ill. People who misuse drugs often have multiple complex problems: they may be homeless; they may have been excluded from their families because of their drug misuse; they may have few friends; and they may lead completely antisocial lives. To get those people back into society requires not only a policeman on the doorstep but a complete holistic service.
	My hon. Friend the Member for Bassetlaw made the point that all those individuals are different—they come from different backgrounds and have had different experiences. In the past, many drug users who went into prostitution were unfortunately from care homes, which was tragic and sad. The Government have taken action by increasing care through social services from the age of 18 to the age of 21. That is one of the ways in which we are tackling the problem, and that point is often not flagged up in debates such as this.

Michael Connarty: My hon. Friend has probably anticipated my intervention by mentioning my hon. Friend the Member for Bassetlaw. By and large, methadone is not used in the experiments in Bassetlaw, and it is not used in France, where a drug that blocks the additional use of heroin, which prevents people from overdosing and from using heroin at the same time as methadone, is used. Is it not time that we did something as a country to try to expand such experiments? I hope to convince people in Scotland, where the main substitute for heroin is methadone, that it is time to examine other drugs that block the use of heroin.

Brian Iddon: I am glad that my hon. Friend mentioned that point, which I shall develop in detail in a moment.

Nigel Evans: The hon. Gentleman has mentioned the psychiatric needs of many drug users, and I agree with him on that point. Although he comes at the problem from a completely different angle from me—he supports legalisation or decriminalisation and I do not—will he concede that many people who now use cannabis, which is completely different from the cannabis that was available in the 1960s, will need psychiatric services in the future if they continue to take the drug at their current pace?

Brian Iddon: I am coming on to that point. I want to knock on the head a few myths about cannabis that have been mentioned again this afternoon. Someone—it might have been the hon. Member for Ribble Valley —said that cannabis is 10 times stronger today than it used to be. Skunk, to which I think that they were referring, contains a tremendously high level of tetrahydrocannabinol, which is the main psychoactive component of all cannabis plants. However, there are 23 different varieties of cannabis plant. I have never taken an illegal drug in my life and have therefore never smoked cannabis, but I take an interest in the subject and have been to an Amsterdam coffee shop. Many people who walk into Amsterdam coffee shops partake of not only coffee but cannabis—all the varieties are laid to choose from.
	When I went to Amsterdam with the police service parliamentary scheme and visited one of the more reputable coffee shops, the gentleman on the counter, who incidentally had been a leading athlete for Holland in the Olympic games, asked me directly whether I had ever smoked cannabis before, and if so what kind. People do not get asked questions like that in Britain—they pick up whatever is on the street and do not have a clue what they are smoking. In Holland, they will be told the tetrahydrocannabinol content. If someone who has never smoked cannabis before goes into a Dutch coffee shop, they will not be sold skunk immediately—they will start on one of the 23 varieties of cannabis with the lowest amount of THC. Some people work their way up the spectrum, increasing the amount of THC content as they become veteran smokers, although I am not applauding that.
	When I go to schools and talk about drugs, I never encourage any children even to try a drug, but we have to tell children the truth. We cannot simply say that the cannabis that is available today is 10 times stronger than it used to be, because that is meaningless and untrue—only one variety out of 23 is stronger. One of the mistakes that we are making is that we are not giving information to children straight. Indeed, in my admittedly limited experience, many teachers do not know the facts themselves, and children often know more than they do about drug misuse.
	One of the best things that the Government have done is to start the "Frank" scheme. I applaud them for that. The "Frank" website gets an amazing number of hits—well into the multi-millions. Young people are hitting the website to find out what they cannot find out from their teachers. One hon. Member quoted the website on the question of cannabis, but that was taken out of context, because one has to read all the information that it provides about cannabis before one gets the full picture.

Stephen Pound: I am grateful to my hon. Friend for his brief guided tour of the cannabis shops of Amsterdam. It is a subject that I do not know a great deal about—or if I did, I have forgotten. Is he seriously suggesting that if I entered one of these cannabis shops, suitably disguised in a wig and kaftan, and ordered a few grams of primo skunk, the owner would say, "I don't think that is entirely suitable for you, sir," and try to steer me towards cannabis indica or cannabis sativa? Surely if one walks into the shop with the guilders, one gets the gear.

Brian Iddon: I was careful to say that I went into a reputable coffee shop. The police are closing down the disreputable coffee shops in Amsterdam, and there are now half as many as there were 10 years ago.

Michael Connarty: My hon. Friend will recall that we visited that coffee shop together and that the athlete whom he mentioned generally advised his clients not to smoke cannabis because he had made it up in other forms that could be chewed.

Brian Iddon: He had been smoking for most of his life, but he was getting a bit unfit and told me that he would not do it any longer.
	The Road Traffic Laboratory has carried out research on the effect of cannabis on drivers. I believe that its report said that one spliff can calm some nervous drivers down enough to make them better drivers, although of course it did not recommend taking cannabis and driving. I am concerned about testing for drugs at the roadside. Cannabis stays in the fatty tissues of the body for up to 30 days—a whole month—but it is not psychoactive and will not affect a person's driving for more than a few hours. Where are the civil liberties in testing somebody six days after they have smoked a spliff, assuming that they have not smoked in between? Surely their ability to drive must be tested at the same time as testing them for cannabis, and what matters is whether they are incapable of driving. We must be aware of that point.
	I do not support total decriminalisation of drugs as the hon. Member for Ribble Valley intimated. However, I recommend that the Government move the debate along and try different methods, as other countries throughout Europe are doing. The problem has only just become stabilised and is not reducing greatly. Indeed, it may increase again—I hope that it does not.
	I supported moving cannabis from category B to category C on the basis of the recommendations of Dame Ruth Runciman's committee, which produced the Police Foundation report on the Misuse of Drugs Act 1971. It strongly recommended the categorisation of drugs according to the harm that they cause. I agree with that. People knew that I had an interest in the subject and many, not only from my community, came to whisper in my ear. Some were professional people—not all were from poorer backgrounds. When cannabis was in category B, distinguished people—I shall not mention names for obvious reasons—approached me to ask me to keep pushing on the door. They knew that some of their children or their friends' children were using cannabis. If they were caught, the family would be stigmatised.
	One of my reasons for supporting the recategorisation of cannabis was my belief that criminalising hundreds of thousands of young people, many of whom did not know what they were doing, was wrong. Criminalisation had all sorts of consequences, for example, for getting visas to visit America and answering the question on job application forms about whether they had ever been convicted of a criminal activity. It is wrong to give so many young people such a bad start in life. It was right to concentrate on category A drugs rather than cannabis, on which the police focused at the time.
	I re-emphasise that we have to get the message about drugs across to young people—for example, through the "Frank" website. We must train teachers who teach children about the moral and ethical aspects of life to give proper advice so that when a child approaches them with a difficult question on a one-to-one basis, they can answer it. The Government are increasingly providing such training.
	One important provision, which is in schedule 2, has not been mentioned in the debate so far. Paragraph 6 repeals the extension of section 8 of the 1971 Act, which was introduced as a result of the Criminal Justice and Police Act 2001. That Act extended section 8 of the 1971 Act to include not only heroin and opiates in general but all illegal drugs. Hon. Members will remember that John Brock and Ruth Wyner, who ran the Winter Comfort home in Cambridge, were caught badly by that. Those two good, honest people ran a home where homeless people could drop in—I have already mentioned the possible connection between some homeless people and drugs—and some drugs changed hands on the premises. I understand that they had been warned but the police invaded and arrested the two managers, who were in prison for quite a long time, despite an appeal and much public sympathy. That case raised fears among many people who worked in housing associations, for example, or who ran community centres—people who were looking after the most vulnerable members of our society. They were all afraid of being trapped by this extension of section 8 of the Misuse of Drugs Act 1971.
	To be fair to the Government, the provision in the Criminal Justice and Police Act 2001 has never been implemented. However, I am not sure whether hon. Members realise that if this Bill is enacted, it will repeal what I regard as that vicious measure, which will give confidence back to the people who help the most vulnerable members of society to try to give up drugs, get themselves organised, and get themselves a home and the benefits that many of those who live on the streets have never had.
	The Bill is about treatment, and I have some concerns in that regard. My hon. Friend the Member for Bassetlaw is absolutely right. When we are discussing drugs, we should discuss each one separately as their profiles are all so different. It is pretty obvious that cannabis is very different from heroin, cocaine and crack cocaine, but they are all different. We must also remember that many members of society are poly-drug users, and I include alcohol and tobacco in the list of the drugs involved. Each drug interacts with the others in a symbiotic way. Taking one drug will not have the same physiological effect as taking a cocktail of drugs, including alcohol and tobacco.
	Sometimes it is difficult to treat a person, especially if they are a poly-drug user. In this country, however, we have gone mad on methadone, methadone, methadone. Methadone is not always the right drug to use as a substitute when treating a heroin user. Since 1997, I have argued in this place that we should offer heroin addicts a choice of treatment, rather than simply sending them down to the pharmacy for the green liquid known as methadone. Of those addicts who take their methadone in the pharmacy, some are of very long standing, and those who prescribe the methadone are so cautious that they prescribe a dose so low that it will not give the addict the buzz that they have been experiencing on the street. We all know what they do: they go down the road, they sell as much of the methadone as they can, and they stick to the heroin that gives them the buzz. Where is the sense in that? We have to titrate methadone according to the tolerance level that the heroin addict has built up, but not many of the people in the community drug teams are able to do that. I have always argued that long-term heroin addicts should be treated by proper professional people, which is what my hon. Friend the Member for Bassetlaw was saying earlier. I entirely agree with him. I know people who have been addicts for up to 35 years.
	I want to raise a point that I feel very angry about. It concerns the General Medical Council, which has been striking off doctors who have been dealing with the most chaotic heroin addicts, particularly here in London, for a long time. The first such case involved someone whom I shall call a friend of mine, Dr. Adrian Garfoot. His brother is a Methodist minister. They were very concerned about drug addicts, and Adrian treated more than 1,000. He said that one of them came at him with an axe one night, but he managed to calm him down. Those are the kind of people that he was dealing with—truly chaotic heroin addicts of long standing who were using cocktails of drugs. We cannot send those people down to the pharmacy and give them a low dose of methadone—it will not work.
	So what has the GMC been doing? I do not believe that it understands these problems. I went along to the GMC to represent Adrian Garfoot at his hearing. He had already been cleared under the Home Office's special procedure; this was his second, unofficial, trial. I looked around the table at all the middle-aged and fairly elderly ladies and gentlemen who were members of the special committee set up by the GMC to try—I use the word advisedly—Dr. Garfoot. They began to ask me questions, we had a conversation, and I concluded that not many of those who were trying this fellow who had been treating the most chaotic drug addicts in London had a clue what his business had been about. Anyway, he has gone; he can no longer practise as a doctor.
	Nearly 30 people have been through the same procedure. All had treated the most chaotic of drug addicts. I do not suggest that they were all angels—there were one or two bad apples among them, and I do not deny that some may not have been doing the right thing—but Adrian Garfoot is certainly an honest, straight man. There are seven more people before the GMC now, and I feel very angry about what it is doing to the Stapleford seven.
	Until he retired last year, Colin Brewer, whom I know, was head of the Stapleford clinic here in London. He is one of the few specialists in the country who can implant naltraxone patches, of which the NHS does not approve because the implantation is intrusive. Naltraxone is a heroin antagonist: try taking heroin when you have a naltraxone patch in your breast. It will make you sick. The patch lasts for up to a month, protecting the patient against heroin during that time. It is not an approved treatment in this country, but I think more research should be done on it, because it is a very good heroin antagonist.
	When I came here in 1997, I argued in favour of buprenorphine, or Subutex, to which my hon. Friend the Member for Falkirk, East (Mr. Connarty) referred earlier. France prefers not to use methadone, and large parts of Australia have gone off it; they use buprenorphine. To be fair to the national health service and the Department of Health, they have introduced it now, but it is still not widely used in Britain. I think that that is a scandal, because in my opinion buprenorphine is far less addictive than methadone, which is an opiate substitute. Buprenorphine has a safer window of operation. It is possible to overdose on it, but not to the extent that it is possible to overdose on methadone.
	A friend who was a synthetic organic chemist— I worked with him at Salford university—came to me with a wonderful proposal, which I put to the Department of Health, but it has gone nowhere. Methadone is a mixture of two molecules, related to each other as the left hand is related to the right. We call them L and D methadone. Only one of those molecules is physiologically active as a heroin substitute. The other stuff is useless and, of course, toxic. My friend developed a process of synthesising L-methadone, in the total absence of the other stereoisomer. That brings down the toxicity level of the same dose, with the same physiological effect, by nearly 50 per cent. in patients prescribed methadone.
	I asked the Department of Health to ask this gentleman to prepare some batches and give the substance a trial to establish whether it was superior to the mixture of molecules that we currently sell people. The Americans are using laevo-alpha-acetylmethadol, or LAAM. Again I tried to interest the Department. It has sent me written replies explaining why it will not give LAAM a trial. What I am trying to get through to the Minister is this: we are unbelievably set on methadone in this country. There are alternative heroin substitute drugs, and we could be a bit more imaginative and at least conduct clinical trials on some of them.
	We must not forget abstinence. Some people prefer 12-step programmes to taking a chemical to get rid of the chemical that is in their body to detoxify the chemical that they have already been on for ages—heroin. We should pay a little more attention to those who want to go straight on to abstinence programmes; indeed, some treatment clinics tell me that we should offer such a choice. It is a question not just of treatment, but of choices of treatment.
	Let me deal briefly with cocaine. Unlike heroin, for which methadone is the substitute drug, there is no substitute for cocaine. One cannot send people down to the pharmacist saying, "This will give you the same buzz as cocaine, even though it isn't cocaine." Such a drug does not exist. Indeed, the police and the Home Office are extremely worried about cocaine. Whereas heroin depresses people and puts them into a state of euphoria—it is a downer, rather than an upper—cocaine, particularly crack cocaine, is an upper, a stimulant. Those who are on cocaine are extremely aggressive, although their lives are admittedly short as they have to keep snorting it or smoking it, according to their preference. Such aggression is why the police are very concerned about people moving from heroin to cocaine—from downers to uppers. We should be very worried about the increase in cocaine sales, the price of which has come down tremendously.
	I want to give the House some hope. Some 18 months ago, I attended a symposium on this subject at my old university, and more recently I heard the scientists speak again. Not many people are aware of the fact that a vaccine is being developed for drug addiction, although I hope that the Home Office and the Department of Health are. Would it not be amazing if, instead of substituting one chemical for another, we could get addicts off all drugs by using a vaccine? I hope that the Department of Health is propelling clinical trials of this vaccine, because it is one of the most hopeful developments in the drug treatment world for a long time.
	I am all in favour of getting as many addicts as possible into treatment, but I am slightly concerned about coercing them into it. They tell me that they will give up a drug only when they are ready to do so. They have usually gone through a pretty horrific process that involved wrecking their family life and committing crime; even so, they cannot—so they tell me—suddenly decide that they will give up the drug tomorrow. Yet that is what this Bill asks them to do. It asks addicts— I am talking about real addicts, not casual users—to sign up for treatment at a time when they are not ready for it. The Home Office cannot simply coerce them into treatment programmes.
	I have a second hesitation. I know quite a few drug addicts who are desperate to get treatment; indeed, my community drug team has a 12-week waiting list. That is far too long to wait. Such teams should open their doors to anybody who wants treatment, as some already do. About three years ago, I spoke to a community drug team leader who operated an open-door policy. Of course, things were chaotic and there were queues for most of the day. Back then, that team had to deal with a lot of drug addicts; indeed, it probably still does, given the location of the practice. My community drug team, however, expects people to make appointments and to turn up for them. If they do not turn up for treatment on the dot, they are put to the back of the queue as punishment. That must be wrong.
	Any addict who has not yet committed a crime, but who might do so because we are not treating them properly, should be able to walk into a treatment centre and say, "I'm ready now: I want to give up my addiction." However, it is not always possible for non-criminalised drug addicts to do so, and that is my second reservation about the Bill. If we are to coerce more people into treatment, what will happen to those who are not yet involved in the criminal justice system—but who might become so—and who want give up drug addiction without going round that magic wheel? I ask the Minister to think about this issue seriously.
	As has been said, we have to follow people all the way through the treatment process—and beyond. All of us with an interest in drug addiction know that relapse with this disease—that is what addiction is, a sickness or disease—is much more common than for any other disease that I know of, including cancer or mental illness, though I have pointed out that some of these people have mental illness, too. They relapse. What addicts tell me is that, when they are having panic attacks or are tempted to go back on the drugs, they need somebody to talk to. It is a matter not of getting an appointment next week, but of getting one immediately.
	I make a plea for 24-hour crisis centres. Having one in every town would be far too costly, but I would expect at least one somewhere in Greater Manchester. Fortunately, some of the leading charities are beginning to develop 24-hour crisis centres. We should think about how much suffering we can prevent and how much money we can save, not to mention how much criminal activity we can stop, by providing someone with the opportunity go to a crisis centre and be saved from going down the dangerous path that they have already trodden.
	I have looked carefully into drug testing, as has the all-party group, of which I am chairman, and we are concerned about some of the firms that are getting on to the bandwagon. Let me say immediately that some of the firms involved in drug testing are credible and competent. However, as we expand drug testing, as recommended in the Bill, we will encounter cowboys jumping on the bandwagon and I know of no accreditation system for firms working in this sector—not even any form of self-regulation. In any case, there are various ways of testing. We can take pieces of hair, urine, blood and body fluids in general, but the most powerful non-invasive mechanism used today is taking mouth swabs, which one company is promoting and the Department of Health and the probation service have started to use. Will the Minister consider whether we should be accrediting such firms, particularly if they are being used by Government agencies?
	I also want to flag up a point about "false positives". It is possible to carry out a drug test on someone and identify a positive. However, if a test is duplicated or another firm tests the same sample, it can appear that the first firm produced a false positive—the person is not, in fact, on the drug that the test seemed to demonstrate they were on. I am very concerned about that. We must have safeguards against false positives.
	One of my constituents was in the Army. He had only just joined and had been in it no more than nine months when the Army carried out a random drug test on him. One day, he was picked out for a drug test and it came up positive. He did have a drug in his body and it was called amphetamine. The problem was that he had had a very serious cold and chest infection and had gone to the pharmacist, who had recommended a prescription that contained—yes, you guessed it—amphetamine. He was not an amphetamine user or addict, but had simply been taking a medicine containing the substance, which was legal and above board. As a result of being identified as positive for amphetamine, he lost his job in the Army. I made some protests to the Army about it, but I am afraid that they were unsuccessful in his case.
	Finally, I want to deal with the inclusion in the Bill of provisions on mushrooms containing psilocin, to which my hon. Friend the Member for Newport, West referred in some detail. I shall not go over the same old ground. I understand why the Home Office wants to include provisions on this matter, but if I were sitting in Committee, I would be asking Home Office Ministers to provide a lot of evidence. The Bill must be evidence-based. The Government use that phrase a lot at the moment: all legislation should be evidence-based. I want to see the evidence that psilocybe mushrooms should be included among class A drugs. I have seen no such evidence, and I hope that my hon. Friend the Minister will say whether a report on those mushrooms has been produced by the Advisory Committee on Drug Dependence. That huge body of experts should know more about the subject that anyone in the House.
	I am not convinced that class A covers the right drugs. People talk about the relationship between LSD and hallucinations, but many people have hallucinations without drugs. The chemical psilocin produces a compound that causes hallucinations in some—but not all—people, so does that merit its inclusion in the class A list, along with LSD? There is even an argument that LSD itself should not be put alongside heroin, cocaine and crack cocaine in class A. That should also be discussed in Standing Committee.
	Around the world, different cultures—the Aztecs, for instance—have long used natural drugs to get their kicks, instead of the alcohol and other drugs used in the west. They have done so safely, and for centuries. Mention has been made of khat this afternoon, but psilocybe mushrooms and khat are only two of the drugs that could be used. I have a list of the chemicals and plants that occur in nature, which people could use. For instance, ibogaine contains a hallucinogenic indole compound.
	The Government want to include psilocybe mushrooms in the misuse of drugs legislation, possibly as a class A drug—an approach that I question. They want to do the same for khat, even though the Somali community has a cultural relationship with the drug. What else do they want to bung in class A? The question of displacement is relevant in this case. The numbers of people using psilocin is very small compared to those using heroin, cocaine and cannabis. Of course I do not approve of the use of drugs such as psilocybin and khat, but is it worth including them in a major Act of Parliament?
	My warning to the Government is that including such compounds in an Act of Parliament might persuade people who do not want to break the law to use other substances instead. A similar thing happens when the police act against prostitutes in one area of Bolton. The result is that they are merely diverted to another area. That is another problem for discussion in Committee. If I were to be a member of that Committee, I should like to see a lot more evidence about psilocybe mushrooms.
	I was asked to speak for longer than normal, and I have.

Henry Bellingham: It is always a pleasure to follow the hon. Member for Bolton, South-East (Dr. Iddon), who I think followed me in the previous debate in this House on drugs. I secured an Adjournment debate on the case of Dr. Adrian Garfoot, to which the hon. Gentleman very kindly contributed. Dr. Garfoot is a constituent of mine, and I shall say more about the case a little later.
	Drug addiction is probably the biggest blight on modern society. It costs many lives, and causes untold misery in thousands of families across the land. In 1954, 317 addicts were registered in this country, but the number had risen to 1,729 by 1967. Last year, 4 million people in the UK used drugs, and the Home Office estimated that 1 million of them used cocaine. Roughly 500,000 of those 4 million people are problem drug users. Replying to parliamentary questions from me, the Minister has said that there are 345,752 problem drug users in the nine English regions. In September last year, a written reply from the Department of Health stated that only 125,913 problem drug users were receiving structured treatment. That means that 219,827 get no treatment at all.
	A number of hon. Members on both sides of the House have pointed out that most addicts are forced into a life of crime to feed their habits. The criminal justice costs of drug addiction are estimated at £16 billion a year. That is hardly surprising when the Metropolitan Police Commissioner estimates that 75 per cent. of all burglaries, robberies and muggings in his force's area are drugs related.
	The supply of controlled drugs, as the hon. Member for Bolton, South-East pointed out, is a vast industry worth more than £8 billion a year. There are more than 100,000 dealers in the UK, but last year fewer than 10 per cent. were convicted of drug dealing. As my right hon. Friend the Member for Haltemprice and Howden (David Davis) pointed out, with profit margins of up to 3,000 per cent., dealers can make a fortune.
	I have described the context in which we should consider the Bill and judge whether it will have any impact or help those who most need it. I have maintained for some time that the criminal justice system has a key role to play in tackling drug addiction and its causes. Indeed, the drugs intervention programme is a good mechanism for identifying, assessing and diverting drug users into treatment. The Government are right to include in part 1 measures to make it an aggravated offence to be found dealing near schools or to use young people as mules to run drugs.
	The Bill will give the police greater powers in relation to dealers who swallow drugs or hide them in body cavities. The police will be able to order X-rays or scans, and magistrates, as my hon. Friend the Member for Ribble Valley (Mr. Evans) pointed out, will be able to remand in custody suspects whom they believe to have swallowed drugs for a period of up to eight days. I support that change.
	I have some reservations about clause 7, which contains a key proposal to amend the Police and Criminal Evidence Act 1984 to allow for drug testing after someone has been arrested for a so-called trigger offence. If that test is positive, the person will have to attend an assessment so that a case plan can be drawn up. At the moment, as several hon. Members have pointed out, a drugs test can be administered only if someone is actually charged. We will discuss the issue in greater detail in Committee, but in the meantime I share some of the reservations of organisations such as DrugScope and Turning Point.
	The main emphasis in the Bill is on the punitive approach and the criminal justice system. However, an equally important priority should be ways to make treatment more effective. The Bill is mostly concerned with those drug users who come to the attention of the criminal justice system, but much more needs to be done to help people before they turn to crime. The national treatment outcomes study estimates that for every £1 spent on treatment, £18 of cost to the criminal justice system can be saved. I was therefore surprised when the Home Secretary said that the figure was £3. Perhaps he was using different statistics from another organisation.
	I am also concerned about the large numbers who drop out of treatment. Indeed, in a recent report, the Audit Commission estimated that 34 per cent. of drug users who leave treatment drop out within the first 12 weeks. According to the National Audit Office, of those offenders who received a community sentence, such as a drug testing and treatment order—which requires that the offender undergo treatment instead of receiving a custodial sentence—in 2003, only 28 per cent. completed the programme. We should not forget those people who have not committed any crime but who could be prevented from committing one by prompt access to treatment.
	I have some concerns about omissions from the Bill. Several hon. Members have pointed out that many people who are dependent on drugs and, in some cases, alcohol also have mental problems. In fact, one third of patients in mental health services have drug or alcohol problems. Many users are falling through the gaps and end up being passed from agency to agency. Furthermore, one in three problem drug users are either homeless or in need of housing support.

Stephen Pound: I am following the hon. Gentleman's argument with great interest. As ever, it is intelligent in every way. Is he saying that the addiction follows the illness, or that the mental illness follows the addiction?

Henry Bellingham: I was saying that the two are often interrelated. There are people with mental illness who happen to have addictions and there are addicts who have mental illness. There is an obvious crossover between the two and that must be recognised.
	As I said, many of those people have other serious social needs; many of them are homeless or in need of housing support. I was interested in the intervention by my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith), who referred to the scheme in Devon, the C-FAR scheme set up by a former Royal Marines major who helps people to work their way back into the community. I feel strongly that services must be able to deal with all aspects of a person's life and place greater priority on providing aftercare for addicts who are leaving treatment.

Cheryl Gillan: My hon. Friend is making an extremely interesting and cogent speech. Trevor Philpott's C-FAR operation is much to be admired. Does my hon. Friend agree that current thinking in some parts of the medical profession, especially the work being carried out by Professor Robin Murray at the Institute of Psychiatry, shows a clear link between cannabis use and the development of inner city psychosis? More such evidence is coming to light and that makes it even more imperative that we look closely at the available scientific and medical evidence, as cannabis is not the innocuous drug that everyone thinks it is.

Henry Bellingham: I am extremely grateful to my hon. Friend for that information. I do not know whether she has visited C-FAR, but I certainly want to do so to look at the work that Major Philpott is doing. My hon. Friend is probably aware of the report issued today by the Royal College of Physicians, which comments on the serious damage that can be done by the stronger types of cannabis; younger people can end up with serious mental illness.
	If treatment services do not deliver, addicts will not be able to rebuild their lives and return to society as productive and fulfilled members. Another omission in the Bill that the Government will have to address is the need for investment in staff training. There is a real recruitment and retention problem at all levels. A recent study by DrugScope estimated that there are at least 3,000 too few key staff with specialist knowledge in drug treatment centres. What does the Minister plan to do to improve the status of all staff who work with substance misusers? What do the Government plan to do about investment in the training, development and retention of staff? When the Minister winds up the debate, perhaps she will touch on that point.
	There is a need for far greater investment and training to encourage general practitioners to work with patients with drug problems. GPs are a key resource and can help people to access other services. At present, there is a huge shortage of GPs qualified to deal with drug misuse and there is no co-ordinated infrastructure to support them. There is obviously a need for much greater liaison and partnership between GPs and specialist agencies, including many in the voluntary sector.
	The hon. Member for Bolton, South-East mentioned the case of Dr. Adrian Garfoot and I, too, want to mention that extremely serious and unfortunate case as Dr. Garfoot is my constituent. Dr. Garfoot trained at the Royal Free Hospital school of medicine and was a GP in Yarmouth and Kilburn. During that time, he developed a deep interest in, and awareness of, the drugs crisis and the plight of drug addicts. In 1990, he opened the Laybourne clinic in east London, which soon became a renowned centre of excellence. During the 10 years from 1990, the clinic treated more than 1,200 patients whose typical age was 37 and a half—substantially older than the average age of patients in NHS clinics, which was 29. The overwhelming majority of Dr Garfoot's patients were long-term addicts who had been injecting themselves for anything from between 20 and 30 years and who maintained their habit through crimes such as theft, burglary, drug dealing, prostitution and so on.
	At one point, it was calculated that the 270 patients attending the clinic had between them spent more than 600 years in prison. It is interesting that the recidivism rate for the drug addicts at the end of the treatment given by Dr. Garfoot at the Laybourne clinic was only 7 per cent., whereas the recidivism rate for those leaving the Prison Service was 50 per cent. In other words, Dr. Adrian Garfoot was able to rebuild the lives of many people, deal with serious medical conditions and restore family relationships, so I appreciate the praise given to him by the hon. Member for Bolton, South-East.
	Most importantly, Dr. Garfoot enabled those people to get on with a normal life and keep out of trouble. I have calculated, with the help of several independent experts, that Dr. Garfoot probably saved the country more than £10 million—a remarkable achievement. His prescribing policy was based on harm reduction and non-coercive user friendly protocols. Above all, he used his clinical independence. He put in place voluntary and supervised withdrawal programmes. No patient ever died from an overdose during his time at the Laybourne clinic. There was one suicide when medication was seized by the police, with the result that the local hospital refused to help.
	It is worth pointing out what the National Treatment Agency of Substance Misuse has said in its recent guidelines and press releases. I quote Professor John Strang:
	"The message for specialist clinicians is that yes, injectable heroin and injectable methadone have a role to play in the treatment of drug misuse—but it's a limited role and one that needs to be developed very carefully".
	There is no evidence at all of any diversion of drugs during Dr. Garfoot's time at the clinic. He was always incredibly assiduous in preventing the diversion of prescribed drugs to the wider community. However, back in 1992, there were complaints. Later, there were further allegations, and he was summoned before a Home Office misuse of drugs tribunal on charges of alleged irresponsible prescribing. After an analysis of 1,500 prescriptions, there was no sign of any discrepancy whatsoever. Dr. Garfoot was cleared by the then Home Secretary and there was a finding of abuse of process against his accusers. The cost of that case ran into thousands of pounds.
	In 2000, however, the interim audit committee of the General Medical Council imposed serious restrictions on Dr. Garfoot. He then went to the professional conduct committee of the GMC in September 2001, and there was a finding that his name should be erased from the medical register on the grounds of serious professional misconduct. He took a decision to appeal to the Privy Council, but, unfortunately, he lost.
	It goes without saying that the case has been a total disaster for Dr. Garfoot, but it is also been an even bigger disaster for the patients at the clinic. The clinic carried on for a while after Dr. Garfoot left, but it was unable to continue to provide the same level of treatment. A number of patients left, 21 of whom have subsequently died. Many others have returned to a life of crime and prostitution, and they are now back on the conveyor belt that leads to crime, inadequate treatment and back to crime again. Only last week, Dr. Garfoot told me that he had two very distressing calls from former patients who were in total despair about the lack of treatment available to them.
	What is also very unfortunate about the case is that, following the Shipman case—no doubt, with the best of intentions—the then Secretary of State for Health, now Chancellor of the Duchy of Lancaster, the right hon. Member for Darlington (Mr. Milburn), insisted that the GMC should increase the period before which a doctor erased from the medical register could apply for reinstatement from 10 months to five years. An exception was made for doctors whose cases had been completed already. No doubt as the result of an oversight, no such provision was made for those whose cases were currently in progress.
	At the time, I wrote to the Secretary of State to say how desperately unfair that was to Dr. Garfoot. He had been advised in writing at the outset—the hon. Member for Bolton, South-East has seen the letters—that restitution could be applied for after 10 months. His case was conducted from beginning to end in line with that regulation. It was not until the case had been completed that he was informed of the changed procedure. I simply submit that natural justice must cut in and lead the Secretary of State to intervene. He should investigate not only the case of Dr. Garfoot, but those of several other doctors in exactly the same position.
	As the hon. Member for Bolton, South-East pointed out, in the year in which Dr. Garfoot was struck off, 20 other prescribing doctors suffered a similar fate. One such doctor was Dr. John Marks. After his clinic in Widnes closed, 42 deaths occurred in two years. The hon. Gentleman also mentioned the case of the Stapleford clinic, which is ongoing and thus sub judice. The situation is serious because we are losing doctors such as Dr. Garfoot.

Brian Iddon: I am not sure whether Dr. John Marks, whom I know quite well, was struck off. I think that his practice in Widnes folded because the health services that were supplying him with patients stopped his funding. He was practising the British system of drug treatment, but that system became unpopular, so we are now using the American system.

Henry Bellingham: I am grateful to the hon. Gentleman. I can check the facts, but I know that the doctor is currently abroad—I think that he is in New Zealand at the moment. The hon. Gentleman will agree that there is no disputing the fact that 42 patients in Widnes died over two years, which is horrific and appalling.
	It is absurd that at a time when we have a serious shortage of GPs, such doctors are not allowed to go back into general practice, at least. It is one thing to strike them off and prevent them from earning their living for five years, but Dr. Garfoot is living in King's Lynn with his father, who is a well known Methodist minister. He is unable to earn a living, but there is a shortage of GPs in the area and practices are crying out for locum support. Such doctors should certainly be allowed back into general practice and be able to return to treating drug addicts in due course, because as I said earlier, there is a chronic shortage of GPs working with drug addicts in this country. I hope that the Minister will address that point in her winding-up speech. If she does not have time to cover the case of Dr. Garfoot, will she write to the hon. Member for Bolton, South-East and me about it? We feel strongly about the matter because an individual has suffered a gross injustice and there has been a huge loss of someone who was able to work with drug addicts, save lives and make a real difference and impact.
	The Bill can make an impact. I support a lot of it, which is why I am glad that we will vote for it. However, it takes perhaps too narrow an approach. The Government can succeed in their drugs strategy, but not if they view the Bill in total isolation. They need to combine it with the wider measures that I cited. If they do that, we can continue to make progress on a non-partisan, cross-party basis.

John MacDougall: I also welcome the Bill because my constituency of Central Fife has had numerous problems with drugs over the years that many of the Bill's measures attempt to tackle. Although many good points have been made today and we will have the opportunity to consider the Bill's measures in greater detail in Committee, we cannot underestimate the devastating impact of class A hard drugs on Central Fife and no doubt on other communities throughout the country.
	Drugs do not have an impact on only the people who use them, but, as the Bill tries to point out, they have a wider impact by indirectly affecting the neighbours of users. I know from public consultations that people complain about finding needles in their back gardens. Unsuspecting children are under immediate threat because their parents cannot protect their well-being. We must find a way to try to minimise the likelihood of such events taking place, and I believe that the Bill addresses that threat.
	The difference between drug use in a poorer community as against that in a wealthier community is that drugs in a wealthier community can be much more easily resourced whereas drug use in a poorer community leads to the accrual of money to fund that habit by illegal means. Therefore, the impact on a poorer community is all the greater. It would be no surprise to find—it would be an interesting survey—that the impact on a poorer community is a higher increase in crime.

Jim Sheridan: My hon. Friend is right to identify areas of drug misuse, especially in deprived areas such as my constituency. Does he agree that the problems could be resolved if people, especially young people, were offered quality jobs and quality opportunities? Would he further agree that projects such as the new deal have particular applications for young people? If the new deal was not in place, there would be even further drug misuse.

John MacDougall: I thank my hon. Friend for raising that point. The ability to finance a drug habit would remove the need to steal, but I am sure that he would agree that the real issue is how to deal with the habit itself and how we encourage rehabilitation. Some of the more interesting points raised today have been about other countries and their approach to drugs. We can all learn from taking into account what does and does not work elsewhere. That is a sensible approach to a complex issue to which I believe there is no one answer.

Cheryl Gillan: I wonder whether the hon. Gentleman can help me on a point of clarification. I have read clause 24(6) and I understand that the significant majority of the Bill applies only to England and Wales and does not cover Scotland. Is that his understanding? As he was speaking, it seemed that he was suggesting that the Bill would affect his constituency in Scotland, and I do not believe that it would.

John MacDougall: I thank the hon. Lady for raising that point. As I said at the offset, I wished to bring to the debate the experience of a community. I was not suggesting that the Bill will impact on that community, but I thought that it would be helpful to the House to learn from the experience that I wish to describe. It is extremely relevant to the content of the Bill.
	Tragically, in Central Fife—I am sure that there have been similar cases in other constituencies—a young man lost his life during the Christmas period. During that period, on two or three occasions when we should have been celebrating, there were headlines in the press and articles that were full of the family's bereavement. The sad feature is that the young man had just come out of prison, where he had been for using drugs. That highlights the point about the need to concentrate on rehabilitation where possible and to accept that not all people will be able to be rehabilitated.
	My hon. Friend the Member for Bolton, South-East (Dr. Iddon) said that we cannot force rehabilitation. A horse can be taken to water but it cannot be made to drink. I accept that there will be people who cannot benefit from rehabilitation. I recognise, however, that excellent work is being done in my constituency through the use of drug treatment and testing orders. We are still waiting to see the outcome of the results, but, so far, they seem to be heading in the right direction. More time will be needed to assess whether there is an upward trend, a hopeful trend, or whether the approach is not as successful as we hoped that it would be.

Brian White: Does my hon. Friend accept that if people relapse, they need extra support to go back on a programme? They should not be written off, as that extra support often makes the difference.

John MacDougall: I agree. My hon. Friend the Member for Bolton, South-East spoke about the need for rehabilitation centres, and cited Manchester as an example. We cannot have them everywhere, but that does not mean that we should not have them at all. If we do the obvious, we simply impose greater responsibilities on the courts, which are already overcrowded, and on the judicial system. That is not helpful to the country.
	Drugs are a complex issue, and we have heard figures about the costs involved. A drug habit is distinct from other habits, as the need to feed it extends far beyond the user and impacts on many others in the community, including the immediate family and colleagues in the workplace. Also affected are schools but, although I agree that there is a problem, it is not as widespread as has been suggested. On several occasions, my constituents have expressed concern that drugs are being pushed in schools. We must consider to what extent that is the case, but we should not exacerbate people's fears, as that does not help us to tackle the problem.
	Drugs have an impact on the health of the individual, and the health service is called on to assist people who have overdosed. Such incidents have implications for the NHS and for the family, who undergo a trauma, and may require medical support themselves. Different drugs have different effects. The difference between cocaine and heroin has been mentioned—one is an upper and the other is a downer—but both bring out another side of someone's character. Some drugs make people aggressive, but others calm them down. Someone who takes a drug that makes them aggressive can be a threat to the community, and that must be tackled, with a cost to supporting services and the courts. The Bill provides us with an opportunity to look afresh at those difficulties that can arise in communities.
	There is a need for strategic working, and local authorities, health services, Parliament and other nations that have experienced the problems of a drugs culture have a key role to play. I recently visited Holland. My hon. Friend the Member for Bolton, South-East spoke about his experiences there, and I found out that Rotterdam had a very different policy from Groningen in the north. There were different geographical and cultural problems—one place was more rural, but the other was city-dominated, so they dealt with drugs differently. Reference has been made to a bold attempt in Rotterdam to remove drug users from the streets. A deliberate political decision was made, and they were banned from the city. However, that only pushed them into other areas, and did not solve the problem. Everything in Holland is not right, but many things there are worthy of examination. For example, the UK has, I believe, adopted its policy of ensuring that addicts have an opportunity to acquire clean needles, which are important in stopping the spread of disease. By taking a positive approach to tackling such problems we are supporting not the habit but an illness. We also prevent disease and avoid the need for further medical support. We can learn from these and other measures, such as the use of methadone, that have been adopted by other countries including Holland and Sweden, which have been highlighted today.
	The Bill complements the Proceeds of Crime Act 2002. The Government have consistently moved in the same direction, with increasing momentum. The 2002 Act deals with a larger and more serious issue. We should not forget that the tragic events of September 11 were largely funded by the proceeds of drugs crime, which trickle down from such a major disaster to the small human disasters in our communities, such as that of one individual losing his life in Central Fife, which is a major disaster to his family. The entire drugs industry causes nothing but chaos and must be dealt with. Drugs are big business, which brings with it, sadly, big pain.
	We rarely get an opportunity to watch TV, so I do not know how many other hon. Members watched a very good BBC television programme on cocaine the other evening. The programme highlighted the economic problems arising from the drugs culture and showed the poor farmers who farm the coca leaves. All they were interested in was earning a living by doing what they do best—growing coca leaves. The coca market collapsed, another buyer offered to buy the leaves from the farmers, and paid not much more than they were getting before, but it was their living so they sold their product, which was turned into cocaine for the market. The farmers had no option. That was their only opportunity to use the skills that they had. The problem was a system that allowed the cocaine dealers to go in and take advantage of people who were trying to earn a living. That economic problem must be tackled if we are to make a difference to the drugs culture.
	I must compliment my hon. Friend the Member for Bassetlaw (John Mann). Because of my interest in the subject through my constituency and through the substance abuse group, of which I am officer, I know that my hon. Friend has, throughout my time in Parliament, shown great stamina in addressing the issue. He has always articulated his case extremely well in the House. His positive contribution today and the warnings that he gave were equally impressive.
	The Bill tackles a serious antisocial problem in our communities. If we do not act, people will accuse us of doing nothing to tackle a problem that impacts upon them in various ways, whether it affects a son or daughter, a distraught mother, a loved one or a colleague who is lost, or some youngster taking drugs at school and influencing other youngsters. The impact on one person affects an entire community, such as mine. I hope the experience that I outlined today illustrates why I believe the Bill should be supported. Without any disrespect to my hon. Friend the Minister, I hope that the Bill will return to the House in improved form, in the best interests of the House and, more importantly, of the people of Great Britain.

Tim Loughton: I do not want to make a long contribution, which is somewhat out of character with the debate so far. It has been an interesting debate, however. I want to make two main points, mostly related to treatment services and the connections with mental health.
	The Opposition support this Bill. It is only a start, however, and will not on its own address the continuing surge in drug use in this country. It must be seen in that context. It might grab some headlines, but it is only one small part of the jigsaw, which we need urgently to piece together. I will support the Bill, because I will support anything that clamps down much more heavily on those who make a living out of peddling this poisonous and destructive trade.
	Throughout this debate, we have heard many figures from different Members. The figures make terrifying reading, however, particularly in relation to abuse and use by young children. British crime survey figures indicate that 12 per cent. of 16 to 59-year-olds have taken illicit drugs in the last year alone, of which 3 per cent. used class A drugs. There are 3 million cannabis users in the country, a quarter of whom are between the ages of 16 and 24, and we know that users are getting much younger all the time. Two in five 15-year-olds in the UK have tried cannabis—more than in any other country in Europe. Certainly, I support any measures to clamp down on anybody trading in drugs around schools and other youth facilities and preying on impressionable youngsters.
	We also need to clamp down on drugs cafés, with which the Bill does not appear to deal. Worthing has had a rather grisly experience of cannabis cafés and how they can lead to the hard drug trade and suck in serious crime and serious criminals to a profitable activity. A couple of years ago, in Worthing, no fewer than three cannabis cafés set up trade in the town centre, one in my constituency, and the other two in the constituency of my hon. Friend the Member for Worthing, West (Peter Bottomley). The one in my constituency was originally set up under the benign, well-intentioned guise of being the headquarters of the Legalise Cannabis Alliance. It was set up almost as a social service, in particular advertising its services to elderly people suffering from multiple sclerosis and rheumatic problems who could come along and have discounted drugs made available to them—very community spirited of it, I am sure.
	The problem was that it was not just the equivalent of a bingo club to which people could come and go and dabble in soft drugs as they please. It became a nightmare for local residents, attracted all sorts of low life, with dealers hanging around near schools, and caused havoc in local mental health residential establishments' halfway houses, whose staff were run ragged because patients were attracted to it. Violence occurred around it, with problems of noise and so on.
	Despite the fact that what was going on was quite plain, it took more than a year to shut down that establishment, notwithstanding several raids by the police and intensive, costly policing. It celebrated its first birthday party with a great big cake—goodness knows what was in it. I was kindly invited to that party, but I declined the invitation. It gloated, however, that it had been allowed to carry on this trade for more than a year. Eventually, due to a lot of hard work by the local council and local police in particular, that café was closed down, to the great relief of local residents.
	Soon after it was closed down, a delegation of those who had run it came to one of my surgeries to complain that it had taken the police so long to close them down. What a waste of police resources it had been to take more than a year to close down what was clearly an illicit activity. It sounds rather comical, but however well intentioned or not one might think that the original people who set up the establishment were, it had been overtaken by some more sordid sorts. More serious hard drugs were circulating through it, and it was becoming a real cash cow and a lucrative little business, with all sorts of criminals getting attached to it. That is what can happen. Regardless of what is and is not in the Bill, the Government must make it much easier for the police—as I hope that certain parts of the Bill may do—to stamp on such activities the minute that those involved put their heads above the parapets. I support any measures that make it harder for such establishments to open up in the first place and easier for the authorities to close them down as soon as possible. I also support any moves that make it easier to close down dealers who, as we have heard from several hon. Members, use children, often as young as 11, 12 or 13, as their runners.
	Dealers are extremely clever in outwitting the police and police raids, and I have seen that problem in my constituency, where they have been getting away with it at one notorious place, which is literally within 100 yd of a local police station. We must make it easier to prosecute those who are clearly running rings round the law as it stands.
	A worrying fall has occurred in the price of drugs. As one newspaper put it, it is now cheaper to buy a line of cocaine, which has fallen in value to as little as £39 per gram, than it is to buy a cup of coffee from a high street coffee emporium.
	I want to raise two main concerns this afternoon. Any strategy to reduce drug use cannot rely purely on law enforcement against the perpetrators and must drastically increase the number of rehabilitation facilities and the extent of drug awareness and education programmes in order to reduce the clientele for drugs in the first place.
	The treatment sector is still massively underdeveloped and too many programmes are not seen through. My hon. Friend the Member for North-West Norfolk (Mr. Bellingham) mentioned that too many people drop out early—they are allowed to do so—from treatment programmes, which must be tightened up. We need many more treatment programmes, but they must be suitable and well policed.
	A little while ago, I visited a clinic for people with various addictions. I sat in a room with people who have drug, mental health or addictive shoplifting problems. I took off my jacket and introduced myself by saying, "I'm Tim. I'm a politician." That seemed to be one of the worst problems in the room—being a politician is rather more addictive than many of the problems for which those people were being treated.
	I was struck by one individual, a young lad of 16 or 17, who had been on heroin and other serious drugs and who had run up a criminal record, mainly by knocking off cars to steal the radios and fuel his drug habit. He had attended various NHS establishments to obtain treatment, where he was invariably fobbed off with methadone as a substitute for his habit. Methadone had not got him off heroin, but the free dose had pepped him up sufficiently to knock off more cars and sell more radios in order to buy heroin, which is what he really wanted. He was in a vicious circle, which that innovatory clinic, based in Kensington, fortunately got him out of by using a completely different treatment. Treatment too often consists of what is easiest and most convenient, because suitable treatment is not available. We must examine how we can treat such people much more intelligently.
	Last year's reclassification of cannabis was accompanied by a wishy-washy, low-impact advertising campaign, which cost the Government rather less than £1 million, to remind people that cannabis was still illegal. It failed dismally, because as we know, nine out of 10 children think that cannabis is legal, and it also failed to mention any link between cannabis and mental health problems. Ironically, when cannabis was reclassified and when the advertising campaign was supposedly highlighting the dangers of drugs, drug education officers were being withdrawn from schools due to a shortage of funds. While central Government were sending out the message that cannabis is not especially harmful, the real message that all drugs are poisonous and harmful, which we must start to put across in schools, was not getting through.

John Mann: For the benefit of the House, will the hon. Gentleman tell us precisely which schools have had drug education officers removed from them?

Tim Loughton: I cannot give the names, but at least two education authorities were cited at the time, a year ago, and it was mentioned in the national press as well. It is not just anecdotal. There were serious pressures on drug education officers in schools at a time when cannabis was being declassified and it was most necessary to get across the vital message that had been distorted by the actions that the Government had wrongly taken.
	I share the concerns of Turning Point, in particular, about the need for treatment in the community for drug users who have not committed a crime and for whom prompt access to suitable, appropriate treatment could keep them off the slippery slope of drugs and crime—the vicious circle that I mentioned.
	In all the areas that I have mentioned there is a need for much better joined-up, inter-agency working between the Prison Service, youth offending teams, schools, youth services, health services, social services and the police. We need to ensure that the professionals are on the ground working at the sharp end with people who have these problems. If we do not get those structures right, the Bill will not count for much. It is just one part of the jigsaw.

Jim Sheridan: The hon. Gentleman is right to say that we need joined-up government. Does he include devolved parts of the UK in that?

Tim Loughton: Drugs dealers are no respecters of national boundaries. It would be crazy if cheaper supplies of cocaine came south across the border from Scotland or vice versa, and absurd if one of the effects of devolution was to create drug soft spots in certain parts of the United Kingdom. I hope that that is not one of the after-effects of devolution. It is absolutely essential that we are tough on drugs, be it through this Bill in this House for England and Wales or through similar measures in other parts of the United Kingdom that the Bill does not cover.
	We need much better joined-up working so that people who have committed low-level antisocial behaviour offences and have not been poisoned by drugs do not end up in custodial sentences shoulder to shoulder with hard-line drug users and pushers. We need to strike the right balance between coercing offenders into drug rehab treatment and ensuring that the right facilities are there for them early on in order to help them kick the drug habit.
	I said that I did not want to speak for long, but I have taken several interventions. My second and final point, and my main worry, concerns the connections between drugs—not least cannabis—and mental illness. My hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) touched on that. The report that came out before Christmas was alarming. We know about the physical effects of drugs, including smoking cannabis. We know that cannabis burns at a much higher temperature than tobacco and that the smoke is drawn much deeper into the lungs, making them much more susceptible to cancer. We know that smoking three joints is the equivalent of smoking more than 20 cigarettes in terms of damage to the lungs. We know that there is evidence that when pregnant women smoke cannabis it brings about changes in the brains of their children that can manifest themselves much later on.
	We know about the physical impacts, but the report that came out before Christmas underlined the potential mental health impacts. There have been about 15,000 scientific papers on the effects of cannabis, but what is different about the paper that came out before Christmas is that it directly links the effects of cannabis to mental health outcomes, particularly among young people. It shows:
	"Half of regular smokers of cannabis who are psychologically vulnerable to its effects may end up needing treatment for psychosis . . . Up to 10 per cent. of the adult population, almost four million people, has a tendency to paranoid thoughts or grandiose ideas and may be tipped into psychotic delusions by the effects of the drug".
	The four-year study of 2,500 people aged 14 to 24 found that, of those who smoked cannabis regularly and had a pre-existing risk of psychosis, no less than 50 per cent. developed psychotic symptoms. That is twice the rate of those who did not use cannabis and more than three times the rate of those who were neither vulnerable nor took the drug. Those figures are pretty alarming.
	Cannabis produces strong psychological as well as physical dependence. It occupies the same receptor sites in the brain as heroin and morphine. In 1997, 200,000 people in the United States were admitted to hospital treatment programmes with cannabis dependence, with 65,000 of them admitted as emergencies. We have already heard that the effect of cannabis in modern times is much more powerful than it was in the 1960s. The average THC content was 0.5 per cent. then, against 5 per cent. nowadays. That depends on the brand, but as we know, skunk is much more powerful than the cannabis of the flower-power period of the 1960s.
	Dr. Paddy Power, a psychiatrist at Lambeth hospital in south London, who has appeared as a witness before the pre-legislative scrutiny Committee on the draft Mental Health Bill, on which I serve, said that cannabis is a factor in 70 per cent. to 80 per cent. of psychosis cases—people whom he sees day in, day out.

Brian Iddon: The hon. Gentleman cites the myth about the THC content of the cannabis on the street today being much higher. Does he accept that much of the cannabis on the streets in Britain today comes from Morocco? When he talks about high THC content, he means the stuff that is grown by people in Britain to sell separately on the street. However, the vast majority of the stuff comes from countries such as Morocco and is not skunk.

Tim Loughton: Absolutely. There are also other varieties. I do not claim that the majority of people use skunk. Many other varieties, which are much more powerful than the average, are readily available. Perhaps it is more worrying that many people do not know what they are smoking. They do not know whether they are smoking something much stronger and whether they can handle it—some people cannot. However, I believe that the hon. Gentleman would agree that the average strength of most of the cannabis that is freely available is much more potent than anything that was available in the 1960s. I do not say that: the scientists do, especially those behind the reports on the links with mental health.
	In 1987, a study of 500,000 conscripts in the Swedish army—one of the biggest studies—revealed that those who admitted at the age of 18 to taking cannabis on more than 50 occasions were six times more likely to develop schizophrenia in the ensuing years. A Dutch study in the American Journal of Epidemiology in 2002 found that those taking large amounts were seven times more likely to develop psychotic illness, and the well-known New Zealand study from Dunedin found that those who used cannabis when aged 15 were four and a half times more likely to develop psychosis by the age of 26.
	According to those studies, in some young people, cannabis may interact with a pre-existing genetically or environmentally determined vulnerability of the nervous system to develop psychosis. Whatever view one takes of the science, even if one does not believe that cannabis and other drugs directly cause mental illness, it is incontrovertible that it can act as a trigger for latent conditions. That is why there is such an increase in those conditions. That costs a lot of money. According to a Professor Henry, an estimated £1 billion a year is spent on schizophrenia. That is 3 per cent. of the NHS budget. Increasing the use of cannabis could cost the health service an extra £330 million annually.
	Reclassifying cannabis was a mistake: it sent all the wrong messages and caused great confusion, especially among young people. Marjorie Wallace, the chief executive of the mental health charity SANE, reiterated her opposition to reclassification. She said:
	"These studies are showing links between cannabis and schizophrenia and illnesses like it, which we have suspected anecdotally for many years.
	In many instances cannabis is the trigger for the schizophrenic breakdown. We would oppose re-classification."
	She went on to say:
	"We have 1,000 calls a week on our helpline, of which 36 per cent. are from psychotics. Among all those young men I have interviewed on the helpline, with only one or two exceptions, cannabis was involved."
	These are people's experiences; these are the facts. We know that obesity and a lack of exercise are the precursors of heart attacks. Now, we are learning to identify the precursors of psychosis. Mental health professionals are warning of these dangers much more than ever before. Dr. Robin Murray has said that cannabis is the No. 1 problem facing the mental health services in inner cities.

Caroline Flint: Professor Robin Murray has now been mentioned twice in this debate. Is the hon. Gentleman aware that, despite Professor Murray's concerns about those who have a propensity to mental illness using drugs of any kind, including cannabis, he was not against the reclassification of cannabis to class C—

Madam Deputy Speaker: Order. I should like to bring the debate to order, and to remind the hon. Gentleman that, although this is a Second Reading debate, it would be helpful if he could now make some reference to the contents of the Bill.

Tim Loughton: Of course, Madam Deputy Speaker. My main reference point is the fact that the Government have not seen the error of their ways and taken the opportunity to change the classification of cannabis in the Bill.
	A particular problem exists in relation to dual diagnosis. People with mental health problems who also have problems with addiction, particularly to hard or soft drugs, are being let down. Theirs are the worst cases of all. All too often, they might be able to access treatment for their mental health problem—or occasionally for their drug addiction—but then have to wait another six to nine months or more to get the other part of the equation dealt with, by which time they have slipped back down the slippery slope. We must ensure that all the appropriate treatment for people with a dual diagnosis is available as a package. It is ridiculous to get someone off a drug problem that has led to a mental health problem without treating the mental health problem. It could lead them to revert to drugs if they have to wait another nine months for the other part of the package. We need much better joined-up thinking when dealing with patients with a dual diagnosis involving drugs and mental health.
	I support tougher measures against those who profit from the drugs trade. I also support measures to make it as easy as possible for the police to act against the real criminals. The Bill will fail, however, unless it forms part of a package that includes better rehabilitation and joined-up services, and better education to teach young people to stay away from drugs in the first place. We need to concentrate on the links between drugs and mental illness.
	We also need to give to drugs, and their link with mental health problems, the same priority that we give to the message that drink-driving kills innocent people, to the message that excessive drinking can rot the liver and lead to violence and premature death, and to the message that smoking can cause heart disease and lung cancer, and can kill us prematurely. All these things—hard drugs, alcohol and tobacco—are poisons that are bad for us when used in excess. The Bill on its own will not achieve these aims, and the Government need to do much more about prevention, education and rehabilitation. If they can do that, the Bill will form an important part—but only a part—of the jigsaw involved in dealing with the real drugs menace that is overtaking too many inner cities and other parts of the country.

Ken Purchase: It is a pleasure to follow speakers of this calibre and to listen to a debate that is so well informed. We have all learned a great deal more about this vexed subject from each other this afternoon than we knew before. To summarise the purpose of the Bill, it is to tackle drug addiction and the harm that it causes to individuals and communities. That is wholly to be commended. I have heard some hon. Members taking a somewhat clinical approach to this matter, concentrating on how we should tackle addiction once it has occurred. I think we must start a little before that.
	Perhaps this is confession time. My first experience of drug-taking was in the early 1950s, when I was an habitué of Wolverhampton and west midlands jazz clubs. To be honest, at that age most of us thought that grass was something you got out of the front garden, but people were smoking it surreptitiously, although there was very little evidence of heroin or cocaine use. We knew the famous American song with the line
	"I get no kick from cocaine".
	In fact, it featured very rarely in the ordinary lives of people out to enjoy themselves. It was very much an American phenomenon.
	It was in the context of my interest in the world of jazz that I was shocked to learn of the death of an icon of the modern jazz movement, Charlie Parker. Some Members may have seen the Clint Eastwood-directed film "Bird", which followed the track of that wonderful musician's life and his downfall through the use of drugs. It featured a scene showing the death of Charlie "Bird" Parker. His middle name, by the way, was Yardbird, which is how he came to be known as "Bird".
	A doctor was called, rushed in and examined Charlie Parker, who was lying on the ground. He started to write a description: "Negro, 14 stone, 5 ft 9 in, aged approximately 70". Charlie's girl friend said "No, no—he is 35." The doctor replied "Well, what a life that guy led! Give me some of it." The truth is, though, that all that magical stuff ended in tragedy simply through addiction to drugs.
	Later in Wolverhampton there was a wonderful UK musician called Tubby Hayes. He was the best—but he was mainlining at the age of 21, and dead at 28. That is what happens to people. At least they have produced wonderful music for other people, but it would have been much better had they not been using drugs. Musicians often say "But you play so much better when you've got that buzz." Charlie always said "I thought that, until it nearly killed me three or four times. You don't play better, you play worse. You just think you are playing better." What sad, tragic incidents there have been.
	In the mid-1970s I was a voluntary worker for a youth organisation in Wolverhampton. At that time there were no more than half a dozen or so known heroin addicts who mainlined. Two of them died, tragically—they were quite young—but not before they had been through the horrendous experience of having terrible cysts on their legs and arms. We used to bathe them in an attempt to do something for them. It was the most awful sight that could be imagined: young people who had done that to themselves.
	When I expressed bafflement—why did those addicts put up with it?—people explained to me that they were "addictive personalities". I am in no position to argue with that: it is probably true that some people have what are known as addictive personalities to a greater or lesser degree.

John Mann: My hon. Friend speaks of addictive personalities. It may surprise him to learn that the overwhelming majority of Bassetlaw's heroin addicts—more than 90 per cent.—come from coalmining communities ravaged by unemployment, rather than from the middle-class or rural communities that happen to constitute half the population.

Ken Purchase: No, it—

Madam Deputy Speaker: Order. May I again remind hon. Members of the content of the Bill that we are discussing this afternoon?

Ken Purchase: Of course you may, Madam Deputy Speaker, and I accept your point entirely. I am trying to demonstrate, for the record, the horrors associated with the consequences of drug taking and with the worst drugs known to humankind. The Government are trying to tackle those horrors, and it is extremely important that such efforts be made. I of course ask for your forgiveness, Madam Deputy Speaker, and I intend to stick entirely to the point of the Bill, which is to deal with those consequences.
	Sometimes, we know more of such matters from our personal experiences than even learned Members of this place can tell us about. The reputation of a Wolverhampton estate that I represent was totally ruined by the presence of drugs, and in just the ways to which my hon. Friend the Member for Bassetlaw (John Mann) referred: through poverty, lack of opportunity and poor facilities, and above all through unemployment and slipping into illicit work patterns such as prostitution, drug pushing and petty crime. Those are the social consequences of having insufficient money to live decent lives.
	The Bill tries to address such problems when they occur, but we have to deal with them before they get to first base. We should not be prepared to tolerate unemployment in the 21st century. We certainly should not tolerate it to the point where whole families are unemployed, there is no culture of work, the work ethic means absolutely nothing and some believe that wealth comes from a giro cheque. Many Members will have been visited at their Saturday morning surgery by, say, a young woman with two or three children who says, "But how do they expect me to manage on this?" What are such people talking about? They mean a giro cheque. They do not know who "they" are. They have no understanding of wealth creation and no knowledge of caring for themselves through going to work. That is the problem that we must tackle. Being sympathetic later to the consequences of drug addiction is hardly a help at all.
	I apologise to those of my hon. Friends who know this subject well—including the technical and clinical aspects—but I must point out what I see, which is absolutely horrendous. The entire population of an estate in my constituency, consisting of 1,200 houses, is now ashamed to say where they live. The situation is improving bit by bit and we are clawing our way up the ladder. Much of the problem is caused by factors such as gangsterism. Wherever there is poverty, we can be sure that a gangster is there who is willing to wind the situation up a bit more, to crush and screw people, and to ensure that part of whatever they do have belongs to the gang or to somebody's minder. We see young women—perhaps not even turned 16—tarted up in the most appalling manner, and we know that they are touting for trade. Allowing such things to happen destroys and demeans us all. Sympathy is fine, but when people are off their heads on drugs and do not know what they are doing, it is too late. We have to deal with the underlying social causes that bring these situations about.
	When I entered this House in 1992, one of the first issues that I dealt with was LSD, the first two letters of which stand for lysergic acid. I do not know what the last one stands for.

Brian Iddon: Diethylamide.

Ken Purchase: I thank my hon. Friend very much. Throughout the 1950s, clever-dick doctors—

Brian Iddon: indicated assent.

Ken Purchase: Throughout the 1950s, doctors conducted a series of clinical trials under laboratory conditions, through which they administered LSD to people suffering, in their opinion, from mental problems. As the hon. Member for East Worthing and Shoreham (Tim Loughton) mentioned earlier, the link between drugs and mental illness is quite well established. These doctors, particularly the one in the west midlands, decided to conduct a series of clinical trials that would determine whether lysergic acid could help to improve mental conditions. The upshot—not just in the west midlands but throughout the nation—was that more than 1,000 people were left, as a result of a closely controlled clinical trial with LSD, with the most severe sort of mental illnesses and disturbances imaginable. It took eight years finally to get a case to court and, in the end, there was a minor pay-out on the grounds that the duty of care had not been fully exercised.
	We all express considerable sympathy and talk about access to treatment, saying that this and that must be done. Even under those near perfect laboratory conditions, however, the application of those unstable substances had unpredictable outcomes on different personalities. Clearly, even under those conditions, we did more damage than good.
	Whatever else is true, we must try to educate our youth on how to avoid the use of drugs—and I include alcohol. Let me say bluntly that the idea of having 24-hour licences—[Interruption.]

Madam Deputy Speaker: Order. I really must ask hon. Members to relate their comments specifically to the Bill. They should explain how their experiences can helpfully shed light on particular provisions in the Bill.

Ken Purchase: Indeed, Madam Deputy Speaker. The question of the police powers granted by the Bill is interesting. The police have many duties and it seems to me that, unless we tackle these problems at source, we shall be placing a load on the police, which is bound to detract from their other important work. We should not exclude from consideration the issue of drunken behaviour, which is a serious problem, as are burglaries and many other crimes that are being committed in our communities as we speak.
	To conclude, it is noble and proper that the Bill should tackle the problems of drug addiction and all the harm that it causes. However, it is even more important to look at how society operates in order to understand how the opportunities are given to the criminal classes to squeeze those who live in poor circumstances. As I say, that is far more important than the Bill itself. I wish the Bill well, but I know that when it is passed and the real work starts, we will still have serious underlying problems—in our nation and perhaps elsewhere—that will ultimately have to be dealt with in social and economic, rather than clinical, terms.

Angela Watkinson: I apologise for my yo-yo attendance during the debate. I was in my place for the opening speeches, but I had diary commitments that pre-dated the time at which I realised that I would be sitting in Committee on this Bill.
	The Bill will command cross-party support, and I am afraid that I have no interesting personal confessions to make on the subject. I want to concentrate on the proposed new subsection 4A(4) to (7) in clause 1—it is an insertion into the Misuse of Drugs Act 1971—which relates to the dealing of drugs in the vicinity of schools. I am a little concerned that the provision specifies one hour before a school opens or after it closes. I wonder whether that will be sufficient. I am a governor of one particular secondary school and I know that it carries out activities over a much longer period than that. Perhaps we could discuss the issue in Committee, as many schools conduct activities in the evenings and have homework clubs, breakfast clubs and so forth going on.

Caroline Flint: The Bill does cover that. The proposal about one hour before and after the school day would apply outside term time too. We recognise that schools are at the centre of their communities and that young people should be able to use them in the holidays as well as before and after the school day. However, we can look at the clause in more detail in Committee, to assure hon. Members on this point.

Angela Watkinson: I am grateful to the Minister for that response. We need to ensure that the restrictions that we put in place will be adequate.
	I shall concentrate on why I think dealers are attracted to schools, almost like bees around a honey pot. I anticipate the intervention that the hon. Member for Bassetlaw (John Mann) wants to make by saying that the reason for that is that schools offer a ready source of customers. As I have said many times, I blame the style and content of drug education material for the level of demand. That material is misguided. We could do more to reduce demand, and the levels of drug taking among young people, if we stopped concentrating on harm reduction and concentrated instead on prevention. Most of the literature used to support drugs education concentrates on harm reduction and on the provision of comprehensive information about every aspect of drugs and their consumption that one could possibly imagine—and about some aspects that one could not imagine.

John Mann: The hon. Lady speaks about drug dealing outside schools. Over the past 10 years, there has been an above-average number of arrests and convictions for drug dealing in my constituency, but I can find no examples of any such incidents taking place outside school gates. Can the hon. Lady give the House specific examples from her constituency of arrests and convictions for drug dealing outside schools?

Angela Watkinson: No, I cannot, but head teachers in my area and the local education authority tell me that drugs are in circulation and in use in our schools. We must do everything possible to prevent that.
	I shall give a couple of examples of printed material that I think is misguided and going in the wrong direction. It may be well intentioned, but its effect is the exact opposite of what we would want. I shall quote a paper by Mary Brett, who is well known to all of us who take an interest in this subject. Until recently, she was head of health education at Dr. Challoner's grammar school in Amersham. She says that the press
	"have widely publicised the true and very alarming picture of the relationship between cannabis and psychosis, and the steady increase in the number of young psychiatric patients, 80 per cent. of whom have a cannabis history. A fact that is well played down by FRANK . . . FRANK merely suggests that 'some people can get anxious and paranoid especially if they are smoking the stronger varieties'."
	By urging young people merely to take precautions and reduce the possible harm caused by cannabis use, I believe that we are missing an opportunity to warn them and so prevent them from using cannabis in the first place. Brett goes on to state:
	"On average, the THC content today is 5 per cent. compared with 0.5 per cent. in the sixties—10 times stronger . . . Its THC strength can vary from 9 to 27 per cent. FRANK says, 'Some people may find it too strong and the experience disturbing, while others may enjoy the greater effects'. What about those who may have an acute psychotic episode requiring hospitalisation? Why mention the fact that 'increasing amounts of this are being home grown for private use'?"
	To Mary Brett's mind, that is almost "an invitation to experiment." She goes on to say:
	"It is irresponsible to say that physical addiction is unlikely. Around 10 per cent. of those who ever try the drug will become addicted according to Professor Wayne Hall, the Australian researcher. And, out of the 6 million drug addicts currently in the USA, around 4 million are cannabis-dependent."
	I imagine that all hon. Members received the briefing paper from the London Drug Policy Forum, in preparation for this debate. The forum is funded by the Corporation of London. It has partnerships with the 32 London boroughs, central Government and regional government, drugs service providers, law enforcement agencies and community groups. It states that its intention is—in the buzz phrase used in all these publications—
	"to reduce the harm . . . concentrating on what works to improve services".
	DrugScope and Turning Point, in their briefing paper which I received today, say that they produced an alternative drugs bill last year, just before Christmas, which
	"emphasises treatment provision, harm reduction and improving the capacity of the health service".
	All those three factors are important, but they will not work unless we reduce the number of new addicts. Providing residential treatment would be wholly unaffordable if more addicts continued to come along. Unless we stop the source, we will not be able to afford to treat the addicts that we have already.
	Then there is "Score". I do not know how many hon. Members have seen that delightful little publication, but it tells people everything they could possibly want to know about drugs—what they are, what they do, every possible drug on the market and what the law says about them. But it is entirely the wrong approach to provide lots of value-free, non-judgmental information to young people who are too immature to make adult decisions with it. They need guidance and they are not getting it.
	Thank heavens—how appropriate—for the Christian Institute, which comes down on the other side of the argument. It comments:
	"Even drugs education does not aim to discourage drug use. 'Harm reduction' in the drugs field is a philosophy which, instead of seeking to prevent drug use, seeks to reduce some of the damaging effects of drug use."

Brian Iddon: I am not sure that I am following the drift of the hon. Lady's comments. Is she suggesting that no harm reduction material be published and people be allowed to die?

Angela Watkinson: No. What I said was that none of those strategies will work without drug misuse prevention. They have to be underpinned by prevention, but that is not happening. Harm reduction is a damage limitation exercise and it is not enough. We need far more than that.

Brian Iddon: The hon. Lady is trying to mix two different things. We all agree that drug abuse prevention and education are important. In fact, I would increase the amount of money spent on that. However, once a young person has embarked on trying cannabis and other drugs, perhaps experimentally to start with, they should surely know what harm they could cause themselves and how they could avoid it.

Angela Watkinson: The two policies are not mutually exclusive. In fact, they fit together. Indeed, the hon. Member for Wolverhampton, North-East (Mr. Purchase) made that very point. We have to get to young people much earlier and prevent them from becoming addicted in the first place. Harm reduction comes afterwards. We need more prevention built into the publications that are available and education programmes. I rarely see any comment that tells young people that drug taking is illegal and wrong, and that they should not do it. Drug literature seems to concentrate entirely on the provision of information—a description of drugs, how to take them, what will happen if they are mixed and what the social effects are. We should concentrate instead on abstinence and prevention.

Alistair Carmichael: Is the hon. Lady suggesting that we return to the days of campaigns that suggested "just say no"? Does she not think that that was demonstrated not to work at the time?

Angela Watkinson: I am saying that, and it has been demonstrated that the current policy is not working either. Perhaps we should try both together. We should tell young people to say no first, but once they are addicted we clearly have to work on harm reduction.

John Mann: Has the hon. Lady seen the fascinating research that has been carried out by DARE in Nottinghamshire? It has shown that saying no to drugs is not the message that works. It has developed programmes to teach children how to say no to things that they do not want to do, including drugs. That has been incredibly effective with 11-year-olds and is now DARE's approach to drugs education.

Angela Watkinson: The DARE project is having a great deal of success. We need to give children the tools to say no. The same applies to sex education—

Madam Deputy Speaker: Order. Once again, I ask hon. Members to relate experiences from their constituencies or from organisations to the content of the Bill.

Angela Watkinson: Thank you, Madam Deputy Speaker. I am coming to the conclusion of my remarks. The tenor of what I was saying was that the chain of events that leads to dealers being attracted to schools, because there they have a ready supply of customers, relates to the style of drugs education in schools, which is, I believe, misguided and does not concentrate sufficiently on prevention.
	The hon. Member for Bolton, South-East (Dr. Iddon) suggested in his speech that drugs might be categorised according to the harm they do. That would put the responsibility fair and square on the users, who are often portrayed as victims, entirely devoid of responsibility for taking drugs. If we give them information about how harmful drugs are, they must take responsibility for their decision to take drugs in the face of all that information. In this debate, drug addicts are being portrayed only as victims. As has been said, 80 per cent. of drug addicts also have mental health problems, but 20 per cent. do not. That 20 per cent., who take illegal drugs for recreational use, must take responsibility for that decision.
	Until that responsibility is taken, we must introduce tough love in what we are doing. As the hon. Member for Wolverhampton, North-East said, it is no good just feeling sorry for people. It is too late for that; we have to prevent them from becoming addicts in the first place. I will support the Bill, especially the strengthening of the law creating an aggravated offence in the vicinity of schools. I wish the Bill fair weather in Committee.

Stephen Pound: Probably few words are used more and mean less than those that describe a particular debate as being of excellent quality and deep erudition, but I venture to suggest that this afternoon we have had such a debate. Certainly, it has been informed and the Members who have spoken have done so not just with the passion and commitment that we would expect, but from a well of deep knowledge.
	Everyone has paid tribute to my hon. Friend the Member for Bassetlaw (John Mann) and I certainly add my voice to those in praise of him. My hon. Friend the Member for Central Fife (Mr. MacDougall) spoke with the authentic voice of his community.
	My hon. Friend the Member for Bolton, South-East (Dr. Iddon) has yet again educated us in such a way that makes many of us wish that we had been his pupils at Salford—[Laughter.] My hon. Friend may not wish that I had been one of his pupils.
	I want to make two points that are relevant to my hon. Friend's contribution. In a throwaway line when he was referring to the problem of drug distribution in Northern Ireland, he said that the IRA was responsible. In fact, hard drug use in Northern Ireland is confined solely to Ballymena, an area where the IRA's writ does not run. That organisation may have many faults but drug dealing is not one of them; we all know who is dealing the drugs.
	My hon. Friend also referred to the need for there to be someone at the end of the phone line when there was a danger of relapse. I have done much work with Narcotics Anonymous, whose mentors are available when someone rings and we hope that we can respond. Often, we can do little other than offer sympathy and support, but the role of Narcotics Anonymous and its unpaid volunteers should be recognised.
	I sometimes worry that I find myself agreeing with the hon. Member for Tewkesbury (Mr. Robertson) rather more than is probably healthy. He painted a glorious vision of a narcotics supermarket on the high street where one could choose between varieties—a pick'n'mix narcotics bazaar.
	Until recently, such bazaars existed—one of them was called Harrods; one was called Whiteleys, and another, Dickens & Jones. Heroin and cocaine could be bought in Harrods. In about 1933, Lady Diana Cooper, the greatest beauty of her age, wrote very eloquently in her diary of spending a weekend with a friend, injecting themselves with heroin in Brighton. She referred to her anxiety of being, as she said, torn between desire and the deed before making the injection. In fact, they had bought the drug at a place called John Bell & Croydon in Wigmore street—so such places existed.
	I hope that, if one thing has marked the excellence and seriousness of the debate, it is that we have perhaps moved on from the possibility of saying that utter prohibition is the answer to anything and that, to paraphrase a statement made earlier, it is possible to win the war on drugs. Few communities in the world do not have a drug problem. I understand that the Inuit were once drug free, but now have a drug problem. We must all face the problem.
	I welcome the Bill because this is a jigsaw that must be brought together, as the hon. Member for East Worthing and Shoreham (Tim Loughton) said. The Bill contains sound, sensible provisions. It may veer more towards the stick than the carrot, but that is the nature of the Bill. I was worried about the prohibition on sale around schools when I first looked at it, but the reality is that people will search out new markets given that cocaine is on a price level with a cappuccino. One of the reasons the debate is both timely and necessary is that, as the prices fall, the need to expand the customer base will become even stronger and, yes, we will see drug dealers around the high schools. That may sound like a cliché from a horror comic, but sadly, it is the reality.
	I support the Bill, except for one small point that has been touched on already: under clause 21, psilocin will be brought within the ambit of class A drugs.
	Khat has been mentioned. I am grateful to my hon. Friend the Minister for her concern about that subject—she has spoken to me about it and has done a lot of research on it—but not everyone in the Chamber, if I may be presumptuous, understands how corrosive, vicious and pernicious the problem of khat chewing is, certainly in my part of the world, west London. Every morning, a plane disgorges its load of khat, which is then taken to Western international market and sold. Large numbers of people in west London chew khat all night long, becoming increasingly aggressive.
	I am sure that most hon. Members know that khat contains a naturally occurring alkaloid, with amphetamine affects. It is masticated and ingested, entering the bloodstream through the gums. People become very voluble and aggressive. They stay out all night, come home in the morning, beat up the wife and try to sleep through the day. We must address that problem, and if other hon. Members are aware of it, I hope that they, too, will bring it to the Minister's attention and possibly that of the Chairman of the Home Affairs Committee.
	I know little of magic mushrooms. To be honest, I thought that they were a cartoon invention; I did not realise that there were such things as what my teenage son calls "shrooms", although he claims no personal knowledge, or rather he denies all personal knowledge. I know about khat, however, and in parts of Hanwell, Northolt and Greenford, people can see the green leaves—the detritus—of a night spent chewing khat scattered around the streets in the morning.
	The extremely efficient and cost-effective London borough of Ealing council obviously sweeps up those leaves at the earliest opportunity, but that vile narcotic spore is there for all to see, and I hope that it is something that we will consider. If we are to bring magic mushrooms within the ambit of the law, let us consider khat because it is a problem that will grow. One reason it will grow is the fact that the drugs trade moves as different drugs become available. MDMA did not exist 20 to 25 years ago, but it is probably one of the most widely taken drugs in urban society today.
	In making perhaps my point of greatest significance, I pick up something that my hon. Friend the Member for Bolton, South-East mentioned when he referred to the British method. That expression was recognised throughout the world until about 1968. It meant that we treated drug addiction as an illness. We had a system whereby people who were addicted to narcotics—they did not have to be registered addicts—could get prescriptions from GPs that could be cashed at Boots or any other chemist. The prescriptions were made out for maintenance doses, and despite what people think about 1960s, this country had a low level of hard drug use.
	What went wrong? A couple of individual doctors, Drs. Swann and Petro, who are no longer with us, absurdly over-prescribed. We ended up with a ridiculous situation in the Criterion buildings in Piccadilly circus, and Dr. Petro famously once wrote a prescription for one-sixth grain tablets of heroin—I am not even sure that one can get them nowadays—on the back of a cigarette packet. The situation got out of control and the response was to throw out all the good of the British method of maintenance and bring in the American method.
	I have spoken to many drug addicts during my life and I always ask them why they take drugs and what stops them giving up. It seems to me that the effect of taking hard drugs is that of hitting oneself on the back of the head with a ball-peen hammer. They move people to a state of near unconsciousness, although admittedly one in which they do not feel pain—it is like being wrapped in cotton wool. Drug addicts say to me, "I take it so it doesn't hurt any more," so in other words they take drugs to stop the cravings and pain.
	We must disaggregate the problem of drugs. We must not think of drugs as cannabis, ecstasy and all the other different drugs. We must think of the individual problems of khat, the foul, pernicious and murderous crack cocaine—I do not have time to talk about that—and heroin. We must consider substitute prescribing and maintenance. We in this country must not think of reinventing the wheel, but perhaps look again at the British system, which worked.

Cheryl Gillan: The debate has revealed that a wide range of views are held on both sides of the House, which probably reflects the complexity of the question of drugs and the problems faced by our society.
	I start by acknowledging the wider audience outside the House and the valuable work on drugs carried out by people throughout the country. Many hon. Members have mentioned the counselling, assessment, referral, advice and throughcare teams in prisons, drug action teams, general practitioners and the voluntary sector. We never underestimate such people's contribution to our society and I never cease to wonder at the time that people give to try to help others with chaotic lives to find a productive way forward.
	I acknowledge the excellent contributions that hon. Members on both sides of the House have made. We heard good interventions on the Secretary of State from my hon. Friend the Member for Buckingham (Mr. Bercow) and my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith). My hon. Friend the Member for Buckingham, like many of us, is rightly concerned about the guidance that will be available for schools and head teachers. I hope that the Minister will touch on that point in her winding-up speech or in Committee.
	The hon. Member for Newport, West (Paul Flynn) is a well-known "legaliser" and is to be commended for his consistent approach to the subject, whether one agrees with him or not. He accused the Minister of producing an atrocious piece of knee-jerk legislation, the like of which he has rarely seen under this Labour Government, if at all. He thinks that the decision to legislate on magic mushrooms is laughable. He believes that the Bill has not been based on evidence—more of that later. However, the hon. Gentleman acknowledged the mental health issues. Indeed, he has been examining those with the Council of Europe. I hope to hear more of those when he is made a member of the Committee that considers the Bill. He is concerned about coerced abstinence against voluntary abstinence and its record of success. Once again, we heard from a classic and genuine legaliser. I hope that in the same way as all of us acknowledge that the hon. Gentleman has been consistent in his approach, he will acknowledge that others are equally genuine in wanting a drug-free society and are starting from that base.
	The hon. Gentleman followed my right hon. Friend the Member for Haltemprice and Howden (David Davis). He should know that my right hon. Friend raised the subject of khat with the Minister. The hon. Gentleman also raised the subject of khat although he is against, as we could imagine, that being included in the Bill. It is to be hoped that we can consider that in Committee.
	The hon. Gentleman also took on board the wider problems in Colombia, Peru and Afghanistan and the supply chain for drugs. It is interesting that he said that he hoped that the House of Lords will throw out the Bill. I do not know whether he knows something that we do not. Obviously the timing of the Bill is an issue.
	That was echoed by the hon. Member for Orkney and Shetland (Mr. Carmichael), who likewise thought that there was more than a whiff of popularism about the Bill, but, like us, he will not oppose it. It is interesting that he raised points that I, too, would want to pursue in Committee on the levels of dealer quantities of drugs and possible regional variations. The hon. Gentleman referred to the practical problems and the issue of holding people for 192 hours. These are matters that will bear much closer scrutiny when we consider the Bill in Committee, where it will be interesting to hear the views that are expressed by Members on both sides of it.
	The hon. Member for Bassetlaw (John Mann), who has great knowledge of this subject, made an excellent contribution to the debate. He challenged the evidence, based on his own investigations in his constituency. The issue of dealing within the vicinity of schools has been brought into question, and the hon. Gentleman referred to a network in schools that passes on knowledge of where to get drugs. The hon. Gentleman and I need issues around that matter to be clarified, so the Minister will have to deal with that.
	The definition of assessors and follow-up assessors has been mentioned. The hon. Member for Bassetlaw criticised the failure of the qualification of assessors, if I might put it in that way. I want to know, and I want to press the Minister in Committee, about the qualifications of those who are providing advice and treatment on drugs. Many people are involved and there are no benchmarks and no qualifications governing them. The Minister could and should have addressed that issue within the Bill.
	I take my hat off to the general practitioners in Bassetlaw because it is obvious that they have been doing a great deal of work. When there is effective intervention in the drug-taking community, we see the results. That has been shown in the accident and emergency treatment for drug overdoses, where there has been a decline in such admissions, as there has been in admissions for other drug-related problems. That is an important development.
	Certain problems underlie the Bill but I am interested in pursuing the idea of the GP having a pivotal role and examining what treatment GPs are able to provide. Too often people who are referred for treatment that they willingly want to have are told, "Go away. It will be three or four months before we can find you a suitable place somewhere." That situation must be addressed, but the Bill fails to do that.
	My hon. Friend the Member for Ribble Valley (Mr. Evans), who made an excellent speech, will be introducing a private Member's Bill—I make no apology for doing a commercial for it—the Drugs (Sentencing and Commission of Enquiry) Bill, which will be in the House in a starring role on 25 February. I hope that my hon. Friend will be speaking to packed Benches, unlike tonight. I hope also that the Minister will respond positively to my hon. Friend's Bill. Indeed, I throw out a challenge to her, as she could easily undercut my hon. Friend's starring role on 25 February by adding the provisions in his Bill to the Drugs Bill.

Nigel Evans: That would make my day.

Cheryl Gillan: I agree with my prompt. It might even give my hon. Friend a day off. He raised the interesting prospect of compulsory drug testing after road accidents, which should be explored.
	The hon. Member for Barnsley, West and Penistone (Mr. Clapham) spoke about drugs and crime as well as the cost of crime in Barnsley. He also referred to the heroin problem. I was not quite sure about his definition of problematic drug users, but he left me with the impression that there was not a seamless set of treatments and interventions in Barnsley. I was particularly worried by his point about reductions in the "Supporting People" budget. I should like the Minister to address that serious problem, as it is not an isolated incident. The "Supporting People" budget is used for drug interventions, but it has been reduced by the Government. The Minister and the Secretary of State may need to take serious action to ensure that it is reinstated throughout the country.
	My hon. Friend the Member for Tewkesbury (Mr. Robertson) made some pertinent points about the Government's mixed message on drugs. By the Minister's own admission, there is such a message; otherwise the Home Office would not have spent £1 million reinforcing the fact that cannabis is still illegal after its reclassification. It is similar to the mixed message on 24-hour licensing and binge drinking—the muddle and confusion must be put right, as it is not good for our society and it is not good government. The message is not consistent or strong enough, and that view is shared in many parts of the House.
	I am sorry that I was not in the Chamber to hear the speech by the hon. Member for Bolton, South-East (Dr. Iddon). By his own admission, it was a Whip-requested lengthy contribution to our debate.

Brian Iddon: I did not say that.

Cheryl Gillan: The hon. Gentleman said that he was asked to speak longer than usual, and so he did. When a lecturer is asked to address an audience there is a danger that he will not know when to sit down but, none the less, the House learned a great deal from the hon. Gentleman's speech. I, too, would like to know about naltraxone and the use of methadone alternatives. It is a reflection on society that we have started to treat maintenance as the norm. Some people should be on methadone for 16 weeks and should be capable of coming off it, but we are maintaining them on it for 16 years. There are therefore some important issues to consider. I have heard about the vaccine to treat addiction, and almost thought that it was a magic mushroom. It appears to be a magic vaccine, but if it is proving advantageous in the tests that are being run, the Government should consider its use. We are familiar with the problem of false positives in drug testing, and must examine it in Committee. We disagree about magic mushrooms, but the call for the evidence base is important, and the Minister must respond to it.
	My hon. Friend the Member for North-West Norfolk (Mr. Bellingham) made a characteristically measured and thoughtful contribution in which he supported the Bill introduced by my hon. Friend the Member for Ribble Valley. He also dealt with the drop-out rates in treatment, which is a concern for all of us. His robust defence of his constituent, Dr. Garfoot, should not pass unnoticed. The hon. Member for Central Fife (Mr. MacDougall) gave us the Scottish perspective, but the Bill does not extend to Scotland. It extends to Northern Ireland, so I hope that the Minister will explain what is happening in Scotland.

Alistair Carmichael: May I bring to the hon. Lady's attention the fact that the provisions in part 1 relating to the amendment of the Misuse of Drugs Act 1971, which is a UK-wide statute, apply north of the border?

Cheryl Gillan: I am grateful for that clarification. I think that it is clauses 22 and 24 that apply to Scotland, but the rest of the Bill applies to England and Wales,

Alistair Carmichael: It is clauses 1 and 2.

Cheryl Gillan: Yes, but I think I am correct in saying that that application is achieved through the medium of clause 24 at the end of the Bill.
	My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) speaks with great authority about mental health matters for my party, and his contribution showed his measured approach to the problem. He tacitly admitted to being addicted to politics among other things. He expressed concern that law enforcement is not enough in the fight against drugs and that treatment is essential. We can all agree on that. There seemed to be some issues with the Minister relating to the linkage between drugs and mental illness and perhaps we will have time to explore that in Committee.
	The hon. Member for Wolverhampton, North-East (Mr. Purchase), who is not in his place, made a guest appearance and talked us down memory lane and through the jazz clubs. My hon. Friend the Member for Upminster (Angela Watkinson) made her usual excellent contribution and quoted my constituent, Mary Brett from Dr. Challoner's, who has done sterling work in drugs education. My hon. Friend raised issues relating to the "Frank" campaign, about which we are all concerned.The hon. Member for Ealing, North (Mr. Pound) brought up the rear, not for the first time, and slipped in a magic little contribution. I commend his work with Narcotics Anonymous. Like him, I call for sound and sensible legislation.
	In his opening remarks my right hon. Friend the Member for Haltemprice and Howden welcomed the provisions of the Bill, and I agree that some of the basics are there. However, the proposals have come at the eleventh hour and are seen by some to be too little, too late. If the Government are serious about enacting provisions that will make a difference to drug abusers and to law-abiding citizens, the Minister will have the opportunity to consider and adopt the amendments and additions that we will table in Committee. I hope she will encourage her hon. Friends to table their own amendments.
	The Bill has been put together in haste, and things that are put together in haste can be regretted at leisure. We intend to propose that khat be added as an illegal drug, and we will examine clause 1 and make sure that its terms are not limited to schools, but include youth clubs, skate parks, arcades and other areas where children gather. We must study the fine wording of the Bill, such as the provision that it is a reasonable excuse if somebody did not know that a school was being used as a school or that there were young people in it. That would allow people to wriggle under the net.
	I am worried about the cash definitions. In the modern economy we know that it is not just cash that is traded between dealers and their runners. Other goods are also traded and I want to make sure that they are included. We want to encourage schools to begin random testing for drugs, and I hope the Minister will consider amendments to the Bill. Testing for class A drugs should extend to under-18s. We want to make it compulsory to complete a treatment programme, and I hope to explore with the Minister the ways in which we could achieve that. We also want to consider offering more residential rehabilitation.
	I believe the Government do not care whether the Bill becomes law or not. The timing of its presentation, so close to a possible election, is cynical, and the Bill has been prepared with extreme haste, which is reflected in its provenance. The regulatory impact assessment reveals that there has been little, if any, consultation. In the words of the Home Office on page 13 of the regulatory impact assessment,
	"No external consultation has been carried out"
	on the provisions on antisocial behaviour orders.
	We know that about seven weeks ago No. 10 hosted a one-off meeting at which the Prime Minister, the Minister and about 20 police officers discussed the Bill's provisions. If, as we all suspect, a general election is called for 5 May, we will have only a very few sitting days and the Bill will have little chance of becoming law unless a deal is done over it. But that will allow the Government to grandstand and trumpet that they have been tough on drugs, and to point to the Bill as the so-called evidence. No. 10 cannot fool all of the people all of the time.
	This is a serious subject, so as a responsible Opposition we will support the Bill, but we will work with the Minister to improve such an undersized piece of legislation. The subject is too important to be thrown away in a flurry of pre-election posturing. I regret that such a valuable opportunity to improve drug treatment and rehabilitation—and even to deal with the wider issues of supply and public health, on which we have not had an opportunity to touch—has been rushed through in an indecent haste by a Government determined to cover all their bases for the next election.
	We all wish to improve our society, and our route as politicians is through legislation. That legislation should be well thought through. We will help the Minister in Committee, and I hope, in the spirit of the Secretary of State's words, that we can improve what is on offer, despite the lateness of its presentation to the House.

Caroline Flint: We have had an excellent debate this afternoon. It has demonstrated that everyone who has spoken, on whatever side of the argument, cares deeply about the impact of drugs and the way in which individual lives, families and communities can be shattered when the misuse of drugs gets completely out of hand.
	Several Members, on both sides of the House, have tried to imply that somehow the Bill stands on its own, and have questioned why it does not cover a number of issues regarding treatment and so on. The reality is that the Bill is part of an overall Government strategy, in which the Home Office leads, to tackle drugs, crime and treatment for anyone who has a drug misuse problem.

Cheryl Gillan: Will the Minister give way?

Caroline Flint: I cannot give way at the moment, as I am going to try to answer all Members' questions.
	The Bill is intended to complement what we have already achieved: unprecedented amounts of resources going into treatment; for once, Government policy that recognises the link between drug addiction and crime and that is trying to stop that vicious circle; and for once, mechanisms by which we can assess what treatment is happening and what is good, indifferent and bad, and by which we can try to address that. The Bill does not stand on its own. It complements what we are already achieving up and down the country, part of which is 54 per cent. more people in drug treatment.
	If we are to have a reasonable debate on drugs, it is important to consider the Bill in context. I remind the hon. Member for Chesham and Amersham (Mrs. Gillan) and other Conservative Members that not long ago we issued to every Member of Parliament a copy of the document, "Tackling Drugs, Changing Lives", outlining in detail exactly what we are doing to expand provision and to tackle problems of supply, treatment, and importantly, prevention. The Bill and the measures contained in it have arisen out of several different discussions, both formal and informal, with different groups that have specialist expertise and knowledge of the problems in relation to both addiction and enforcement of the law. That is why we have considered measures that, rather than standing on their own, will enhance what we are already trying to achieve.
	I want to deal with a number of comments that Members have made. If I do not respond to all of them, I will have to write to the Members concerned, or take up the issues in Committee. First, I want to comment on khat, which was mentioned by the right hon. Member for Haltemprice and Howden (David Davis) and my hon. Friend the Member for Ealing, North (Mr. Pound). We take the issue seriously, and I have dealt with an Adjournment debate on this very subject. Currently, we are keeping the status of khat under review. Positively, we have arranged with Turning Point and the National Association for the Care and Resettlement of Offenders to undertake two studies considering the level of khat use and misuse in communities. On top of that, we are actively considering what is necessary to communicate and engage with those communities for which it is a problem. That issue has been raised with me by members of the Somali community, in relation to how we get across information to them about the dangers of that drug. We are therefore actively considering that area.
	Issues of organised crime were also raised. The Serious Organised Crime and Police Bill is currently going through the House, and I spent two days on it in Committee last week. We believe that the establishment of the Serious Organised Crime Agency and extended powers in terms of Queen's evidence and disclosure will greatly assist us in putting behind bars more of the Mr. and Mrs. Bigs who run organised drug crime and other forms of organised crime. That is another piece of legislation that complements what we are trying to do in tackling the problems of drugs in our communities.
	On children and the aggravated offence of drug dealing in the vicinity of schools, my hon. Friend the Member for Bassetlaw (John Mann) pointed out that no direct evidence exists and that no figures are kept, but a number of different groups, parents, teachers and others have raised their concerns. We are examining how we can introduce preventive measures as well as how we can deal with the current situation. The legislation is directed at areas rather than children per se because the aggravating factor of targeting vulnerable people, which includes children, already exists, and we felt that that particular area was covered.
	On mandatory sentences, I have not had a chance to see the private Member's Bill promoted by the hon. Member for Ribble Valley (Mr. Evans). However, I remind him that section 110 of the Powers of Criminal Courts (Sentencing) Act 2000 requires the court to impose an appropriate custodial sentence of at least seven years on a person convicted of three class A drug offences. We must see the detail of the Bill before we explore that area further.
	On drug testing in schools, the Department for Education and Skills guidance is clear. It provides advice and a number of measures, one of which is drug testing, for schools. Drug testing must sit alongside a school policy on what to do after a positive drug test. It is one part of the guidance, but knowing what to do and how to connect with agencies that might assist an individual young person who has a substance misuse problem is a real issue.
	On testing equipment, a number of hon. Members raised the issue of how long drugs remain in a person's system. For example, cocaine can be out of a person's system within a couple of days, whereas cannabis remains for a lot longer. There is therefore a danger that we will not pick up those young people who are involved with class A drugs and that we will pick up the ones who may use cannabis. Drug testing is an option that should be open to schools, and where schools use it, we should examine how to support them.
	On testing under-18s at the point of arrest, in the past year we have started to examine testing on charge for under-18s, and there will be provision to extend the age group, but at this stage we need to see how the testing process works with that particular age group.
	A number of issues have been raised about the reclassification of cannabis, which is obviously not included in the Bill. We must have a credible discussion about the relative harm caused by different drugs. An evaluation of the Government's public information showed that 93 per cent. of under-18s understood that cannabis continued to be illegal after its reclassification. Estimates from January 2004 indicate that we have saved about 180,000 police hours in relation to the bureaucracy that was generated by policing the old offences that applied to cannabis.
	I remind hon. Members that the Home Affairs Committee agreed that we should reclassify cannabis from class B to class C, which was supported by the hon. Member for Witney (Mr. Cameron), who is currently responsible for co-ordinating Conservative party policy, and which the hon. Member for Woking (Mr. Malins), who is part of the Conservative home affairs team, did not vote against. It is not always clear where people are coming from on this issue.
	With the Department for Education and Skills and the Department of Health, we are developing a series of health messages that will ensure that we get it across that serious issues exist in relation to the use of cannabis. We are working with a number of people who are involved with mental illness and mental health to ensure that materials are produced that make people aware of the dangers of using any drug, including cannabis, if one has a mental illness. The National Treatment Agency and the Department of Health have taken up dual diagnosis. It is important to ensure that we recognise the different issues, whether they concern mental illness or drug addiction.
	I reject the suggestion that magic mushrooms are harmless, because they are equivalent in effect to LSD. The rapid increase in outlets selling magic mushrooms in what we consider a prepared form, which is illegal, has caused problems. The National Association of Alcohol and Drug Abuse Counsellors has said that it feels that the area needs to be clarified, which is why we have gone down this route. Indeed, a recent court case clearly made that point.
	On legalisation, all I can say is that I am afraid we do not believe that it is a panacea or answers all the questions. Those involved in organised crime would simply regroup. If one legalised drugs and said to the public, "You can have a certain amount of that drug at a certain price," some criminals would try to undercut that price or offer more drugs than would be available through a regulated outfit.
	The hon. Member for Orkney and Shetland (Mr. Carmichael) raised several issues relating to certain clauses that we can discuss in more detail in Committee. I should say that these measures originate from those on the front line who feel that gaps and loopholes allow dealers to get away with being charged for dealing offences. As regards detention, we are trying to target dealers, not mules.
	My hon. Friends the Members for Bassetlaw, for Barnsley, West and Penistone (Mr. Clapham) and for Bolton, South-East (Dr. Iddon) made excellent speeches that drew on their experiences and knowledge of their constituencies. I agree with my hon. Friend the Member for Bassetlaw that we need to ensure that those involved in carrying out assessments and offering advice are able to do that job. If he wants to come and talk to me about his concerns, my door is open. We are looking to the National Treatment Agency to ensure that people are accredited. We are also encouraging more GPs to take up a role in this respect, as the fact that many have not wanted to do so has been a big problem. In the past year, we have worked with the Department of Health to ensure that primary care trusts take that responsibility more seriously. I hope that we can grow a new generation of GPs who see it as part of their core business.
	I thank my hon. Friend the Member for Barnsley, West and Penistone for his remarks about how well drug action teams and crime and disorder reduction partnerships are working in his area. He proved that the resources we are providing are making a difference on the ground.
	I commend my hon. Friend the Member for Bolton, South-East for his work on the all-party group on drugs misuse. He raised several issues. I agree that we need to consider substitutes other than methadone, and the NTA is actively considering that. We should be mindful of the need to give users choice, and we will address that proactively and in more detail in future.
	My hon. Friend the Member for Central Fife (Mr. MacDougall) was right to cite his experiences as a Scottish MP. I hope that the debate will be listened to in Scotland and that likewise we will listen to the debates in Scotland. He mentioned our measures on the proceeds of crime, which mean that at last we can take the assets from drug dealers. That, together with other sentences, will make a real difference to their lifestyles, as well as their investment in their drugs businesses.
	The hon. Member for Ribble Valley talked about the level of drug use in the UK compared with the rest of Europe. Those statistics are open to question and some of the figures are misleading. I am prepared to discuss that with him another time. Drug use in the UK has stabilised. I am not excusing its high level, but there have been rapid reductions among young people in several areas.
	The hon. Member for Tewkesbury (Mr. Robertson) expressed concern about cannabis and talked about the importance of teaching people about the dangers of drugs. That is exactly what we do through Talk to Frank, Blueprint and every other means at our disposal to engage with young people in whatever environment they may be, whether in school, youth clubs or elsewhere.
	We have had a very interesting debate. This is an issue that we can never give up on. I do not like the term, "Fighting the war against drugs." We have to be mindful of how drugs change, and when new drugs come into our communities we have to be prepared to deal with them. The Bill allows us to build on our already positive record.
	As my hon. Friend the Member for Wolverhampton, North-East (Mr. Purchase) said, this is about prevention as well. That is why we are working actively with the Department for Education and Skills to go back to the point before young people get involved in drugs. We want increasingly to consider the risk factors that may lead young people into drugs, early sexual activity, truancy or simply not thriving in school. If we can get there early enough, we can challenge some of the dangers that can lead them into crime and imprisonment in future.
	I commend the Bill to the House and look forward to debating it in far more detail in Committee.
	Question put and agreed to.
	Bill accordingly read a Second time.

DRUGS BILL (PROGRAMME)

Motion made, and Question put forthwith, pursuant to Standing Order No. 83A (6) (Programme motions),
	That the following provisions shall apply to the Drugs Bill:
	Committal
	1.   The Bill shall be committed to a Standing Committee.
	Proceedings in Standing Committee
	2.   Proceedings in the Standing Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 3rd February 2005.
	3.   The Standing Committee shall have leave to sit twice on the first day on which it meets.
	Consideration and Third Reading
	4.   Proceedings on consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.
	5.   Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.
	Programming Committee
	6.   Standing Order No. 83B (Programming committees) shall not apply to proceedings on consideration and Third Reading.
	Programming of proceedings
	7.   Any other proceedings on the Bill (including any proceedings on consideration of Lords Amendments or on any further messages from the Lords) may be programmed.—[Ms Prentice.]
	Question agreed to.

DRUGS BILL (MONEY)

Queen's recommendation having been signified—
	Motion made, and Question put forthwith, pursuant to Standing Order 52 (1) (a) (Money resolutions and ways and means resolutions in connection with bills),
	That, for the purposes of any Act resulting from the Drugs Bill, it is expedient to authorise the payment out of money provided by Parliament of—
	(a)   expenditure incurred by the Secretary of State by virtue of the Act;
	(b)   any increase attributable to the Act in the sums payable out of money so provided under any other Act.—[Ms Prentice.]
	Question agreed to.

EUROPEAN DOCUMENTS

Motion made, and Question put forthwith, pursuant to Standing Order No. 119 (9) (European Standing Committees),

eEUROPE 2005 ACTION PLAN

That this House takes note of European Union Document No. 9675/04 and Addenda 1 and 2, Commission Communication on an update to the eEurope 2005 Action Plan; welcomes the actions proposed by the Commission as a follow-up to the mid-term review of the Plan; and supports the Government's objective, during its Presidency of the EU, of ensuring that the 2006–2010 Action Plan contributes positively to the enhanced deployment of Information and Communications Technology (ICT) in business and in the public sector, thereby contributing to the goals of the Lisbon Agenda.—[Ms Prentice.]
	Question agreed to.

COMMITTEES

Ordered,
	That Kevin Brennan be discharged from the Public Administration Committee and Iain Wright be added.— [Mr. John McWilliam, on behalf of the Committee of Selection.]
	Ordered,
	That Caroline Flint be discharged from the Administration Committee and Kali Mountford be added.—[Mr. John McWilliam, on behalf of the Committee of Selection.]

PETITION
	 — 
	Isobel's Law

Paul Truswell: I have great pleasure in presenting a petition that has been signed by more than 4,000 of my constituents and others in support of a ban on doorstep cold calling for property repairs and maintenance. The national campaign has come to be called Isobel's law. It is named after Isobel Gray, an 82-year-old lady who was brutally murdered by intruders associated with bogus repairers.
	I am grateful to all the individuals and groups that have collected signatures. I would also like to express my gratitude for the support of the Yorkshire Evening Post on the campaign, to Brian Steele, the former detective chief superintendent who investigated Isobel's death, Stuart Pudney of the Trading Standards Institute and Councillor Mick Grubb, who has been awarded the Queen's police medal and is chair of Horsforth town council. As a former police officer, he tackled cases of distraction burglary and property crime.
	The petition states:
	The Petition of the residents of Pudsey constituency and others declares
	That communities and individuals, particularly older citizens, require far greater protection from the activities of bogus and exploitative property repairers and notes that the Government is currently consulting on a range of possible measures to combat these and other activities involving cold calling.
	The Petitioners therefore request that the House of Commons enact legislation that will ban doorstep cold calling for the purposes of offering property improvement, repair or maintenance.
	And the Petitioners remain, etc.
	To lie upon the Table.

MEDICAL SERVICES (NORTHUMBERLAND)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Watson.]

Alan Beith: I am glad to have the attention of the Minister with responsibility for public health on the problems that we face in Northumberland because, in more than 30 years of representing Northumberland in Parliament, I have never received so many complaints and representations about failings in the local health service as I have had since the new out-of-hours system was introduced last September. Patients and their families are angry about it, and professional nursing and ambulance staff are concerned that they are expected to make decisions without the back-up of a doctor and that they have to explain to patients that they need to be taken 50 miles for treatment, which used to be available locally from the GP on duty.
	Once the Government signed the new GP contract, under which practices no longer have responsibility for cover after 6 pm or at weekends, a system had to be created to replace them. That was difficult enough, but it is even more difficult in a scattered rural area where patients are at least 20 miles and often 50 miles from a general hospital. We rely on the infirmaries in Alnwick and Berwick, the community hospital at Rothbury and GPs for a wider range of services than is necessary when there is a major hospital nearby.
	Two problems were clear from the start. First, it would not be adequate to have one doctor to provide sole cover for three hospitals and home visits in an area of 1,000 square miles, yet that is all that was thought necessary between midnight and 8 am. Secondly, most local GPs did not want to take part in the new service, so it depended on bringing doctors in from London or Wales, or flying them in from Germany at high rates of pay—£115 an hour in some cases. Apparently, £1,000 a night is the going rate in some other remote areas.
	I was told about a German doctor who likes to play golf. It is difficult to get on the golf courses in Germany at the weekend. He therefore comes over, does a weekend's work and has a good income and a good living out of that work in England. He flies back to Germany on a Monday and gets on the golf courses for the whole week. This has helped us out in a crisis, but it does not seem to be quite the right way to run our health service.
	The arrangements are the joint responsibility of two trusts. The hospitals come under the Northumbria Healthcare NHS trust, while house calls are the responsibility of the Northumberland Care trust. The names are confusing enough. The primary care trust has had a financial crisis leading to the resignation of its chairman and chief executive, and the joint chief executive of the hospitals trust is now doubling as acting chief executive of the primary care trust. One benefit of this presumably temporary situation is that there can be a single focus of responsibility for putting matters right. I have discussed the problems extensively with the chief executive and I expect to have a further meeting with him in the next few weeks. Indeed, I have been having meetings with the health authorities since before this new arrangement began.
	The same doctors provide the service for both trusts, but they are engaged by an agency, Northern Doctors Urgent Care, which is located well outside the area, at Longbenton, on the edge Newcastle. The same organisation provided GP night cover in parts of my constituency before the new system came in, but it was then more closely integrated with the GP service.
	In some cases, the arrangements have broken down completely. For example, on 26 November, three local councillors attended Alnwick infirmary to observe the new arrangements. At 6.30 pm, no doctor was present to support the busy casualty department or to do home visits. At 8 pm, the hospital was told that a doctor was on her way from London, but that the train was late. At 8.30 pm, the doctor arrived at Newcastle station, 30 miles away, but there was no driver for her. She eventually arrived at 9.40 pm. There was no back-up or alternative cover.
	On another recent occasion, a dying patient in a care home needed pain relief, which could not be prescribed by the care home staff. The doctor who was at the infirmary a mile away could not attend because no driver was available. It did not seem to occur to them to call a taxi, although there are plenty available. The patient had to be put into an ambulance, and died on the short journey to hospital, without the comfort and dignity to which she was entitled in her final hours.
	I have been told of one occasion on which a doctor was brought more than 60 miles from Newcastle to write a prescription for pain relief in a similar case because no doctor was available locally. In another case, which I took up with the trust as a complaint, a doctor did not arrive to see a leukaemia sufferer with suspected pneumonia for 12 hours after her sister had called the emergency line. The doctor arrived at 9 pm on a Saturday, the call having been made at 9 am.
	For many patients, the consequence of the change has been long journeys to Wansbeck hospital, which is in Ashington, more than 50 miles from Berwick. These journeys tie up an emergency ambulance for two hours. Some of the visiting duty doctors will apparently not carry out basic procedures such as stitching, saying that it is not in their contract. The acting chief executive of the care trust has admitted in a letter to me that the agency was
	"relying on doctors who, although clinically competent, were not as experienced in the local provision of healthcare."
	As a result, many more patients are being taken by ambulance to Wansbeck hospital, where ambulances have been queuing up to get patients in. The health care trust admits that it has
	"seen an unprecedented rise in the number of admissions and A and E attendance",
	part of which is clearly caused by the new out-of-hours system.
	So serious is the crisis at Wansbeck that a third of the beds at Alnwick infirmary have now been temporarily closed so that staff can be shifted to Wansbeck in an attempt to relieve the situation. The ambulance service is having great difficulty in meeting the increased demand caused by moving so many patients so far at night. Serious gaps in the emergency ambulance cover in the rural area are inevitable while ambulances are detained so far away. In many cases, the ambulance is being expected to take the place of both the local hospital and the doctor's house call. Nursing staff have been issued with instructions that if a patient on a ward has a cardiac arrest after 6 pm or on a bank holiday, they should ring 999. I have here the piece of paper that they were issued with. Clearly, some conditions could make such a 50-mile transfer—or a 40-mile transfer to the Borders general hospital at Melrose—essential. However, many cases could be dealt with locally, and they should not be filling up the larger hospitals or diverting the hard-pressed ambulance service.
	The way in which most people approach the new service is to ring an emergency number. One of these numbers connects them to NHS Direct, where they have to explain first to an operator and then to a nurse why they are in urgent need of a doctor. If they get through those hurdles, they will be transferred to an operator at Northern Doctors Urgent Care, where, no matter how distressed or anxious they are, they will have to go through the whole explanation again, possibly twice. If they are successful in negotiating this obstacle course, they will be told that a doctor will ring them, although that could take up to an hour. A visit is still further away.
	So what people do, if they can, is get into a car and get driven to the infirmary, where they might be told that no doctor is available. They might then have to drive another 50 miles to Ashington, where they will queue up with those who have been brought in by ambulance. I understand that the care trust is reconsidering the multiple-triage system with a view to eliminating NHS Direct from the process. That would certainly be an improvement. Leaflets have been issued, including the Northern Doctors Urgent Care number, which should also be on the answerphones of all GPs' surgeries.
	A separate problem arises from the fact that patients no longer have access to doctors on Saturdays for relatively urgent but non-emergency consultations. People were astonished when notices suddenly appeared in every doctor's surgery saying that there would be no more Saturday morning surgeries after 1 September. I raised the matter in the House on 14 September. The Secretary of State replied that under new national requirements there would be,
	"should a patient's condition require it . . . access to a Saturday morning surgery."—[Official Report, 14 September 2004; Vol. 424, c. 1114.]
	That does not appear to be happening. Someone who has struggled to work all week with a bad bronchial condition may want to consult the doctor on Saturday to establish whether he or she is fit to return to work on Monday. The only recourse is to go to accident and emergency and ask the doctor to deal with the case as an emergency, alongside all the injury cases. Casualty departments are not equipped or specifically trained for work of that kind. They are busy dealing with injuries.What is supposed to be happening to meet the Saturday surgery requirement that the Secretary of State set out so clearly in the House, and what information will be given to the public? I hope the Minister will be able to make that clear.
	I also hope she will tell us whether there are examples of best practice in new arrangements for out-of-hours care in other remote rural areas. If there are, I should like the health trusts in our area to take them up.
	I am sure it cannot be said that the defects of the new service are a result of attempts to do things on the cheap. It must be fabulously expensive, given the very high rates being paid to entice doctors from Germany and the great increase in ambulance journeys, as well as the cost of staff transfers to deal with the increased pressure on Wansbeck hospital. There really must be a better way of using this money to provide a service that is tailored to local needs.
	There are certain requirements for that service. Given that doctors must cover both hospital and home-visit cases, we need a doctor in Berwick and a doctor in Alnwick throughout the out-of-hours period, and each must have a driver. Sometimes one is shared between two places, which is a hopeless arrangement. Even an account with a taxi firm would be an improvement on circumstances in which a doctor cannot go out on calls. A back-up arrangement with local doctors needs to be in place in case doctors cannot reach an urgent case, or are delayed as they fly in from wherever they are coming from. I should like to see a major effort to attract local GPs to participate in the service, and I hope the Minister agrees.
	More forms of treatment should be available at local hospitals to reduce the number of long-distance ambulance transfers that the system has generated. Staff should feel that they have adequate back-up and are doing work that is appropriate to their training and grade. The public should be able to speak to a doctor by telephone in urgent cases without having to go through numerous intermediaries, and should be able to secure a house call when it is needed. Saturday morning surgeries should cater for all patients who cannot reasonably be expected to put off seeing a doctor until Monday, or who have real difficulty in attending during the working day.
	All those services were available in Northumberland when we had a GP-led out-of-hours service. Now they are not, and people are very angry about what they see as a serious and threatening reduction in the national health service. The care trust has stopped saying, as it said last August, that patients would see no difference in the standard of service. Today, I understand, it has said it is "different but adequate". It is certainly different, and it is costing a lot more money; but it is an inferior service. It is not adequate, and I want Ministers to act to help put it right.
	Today the Northumbria health care trust issued a press release announcing that the two trusts have agreed jointly to review the urgent-care system across the county. That may be the first result of today's debate, but the review needs to be fundamental, starting with patient needs rather than with the trust's existing structures. It needs to examine alternative models for the provision of out-of-hours care in scattered and remote rural communities. It needs to consider how we can increase, rather than decrease, the role of local hospitals in Alnwick, Berwick and Rothbury. It needs to consider the fact that extensive medical equipment and facilities in GPs' surgeries, which were provided with the support of public funds, are locked up and unused from 5.30 on Friday until 8 o'clock Monday morning, and throughout the Christmas and new year periods. It needs to consider reducing dependence on flying in doctors from the south and from Germany at vast expense, and to look for ways of attracting the support and involvement of as many local GPs as possible. It needs to make use of best practice in other remote rural areas; above all, it needs to listen with an open mind to the concerns of patients, NHS staff and the community. It is those concerns that I have tried to voice tonight.

Melanie Johnson: I begin by congratulating the right hon. Member for Berwick-upon-Tweed (Mr. Beith) on securing this debate. I know that this issue is very important to his constituents, and particularly to the families and others whom he mentioned or alluded to; I join him in recognising that importance. I am sure that he will join me in congratulating the NHS staff in Northumberland on their work. They are dedicated to delivering high quality services and they deserve our admiration; they doubtless enjoy his, as well as mine.
	I want to begin by saying a little about the policy of out-of-hours medical care. We said that we would introduce these changes in April 2002 and as a result of them we have devolved funding locally, so that people can get the services that they deserve locally, and that decisions can be made at that level. The right hon. Gentleman doubtless fully endorses that principle, given that he believes in taking as many decisions as possible at a local level.
	The change to the contract supports the development of an integrated system of high quality out-of-hours care. The right hon. Gentleman said little about integrated systems but he mentioned other good examples of such provision, to which I shall come in a moment. The previous arrangement often involved sub-contracting out to GP co-operatives, but now practices can themselves transfer such responsibilities to primary care trusts, as the lead commissioners of NHS services in their areas. That enables PCTs to rethink and reconfigure the provision of out-of-hours services, and to co-ordinate them with other services such as accident and emergency, social care and NHS walk-in centres, where such centres have been opened. The long-term aim is to have a seamless, integrated and unscheduled care network that brings together all services in meeting patients' unplanned needs.
	I recognise that the right hon. Gentleman's comments suggest that the situation in Northumberland is not working out as it should, but before I deal with the points that he raised I want briefly to mention the investment that we are putting in. As he rightly said, we have increased such investment significantly. We have doubled this year's out-of-hours development fund to £92 million, we have provided additional resources of £14 million to assist PCTs in very rural and urban areas, and we have made available to PCTs £30 million in capital incentives. In addition, some £180 million is available that was previously given to practices to pay for out-of-hours services; under the new contract arrangements, that money goes to the PCTs. To save the right hon. Gentleman some arithmetic, that totals some £316 million.

Alan Beith: As I understand it, Northumberland does not qualify for the rural benefit because it is a mixture of a very urban area and an enormous rural area. The Minister might like to consider that point.

Melanie Johnson: I am very happy to do so and the right hon. Gentleman may well be right. A number of mixed areas sometimes fall foul of this problem; none the less, there has been investment in the health service in Northumberland as a whole, and a big increase in the number of GPs—from 231 in September 2001 to the current figure of 272. That is an increase of 18 per cent., so it amounts to a substantial increase.
	I have already mentioned the arrangements that we believe should work and the opportunities that they provide. As the right hon. Gentleman knows, GPs in Northumberland opted out of providing cover out of hours, although 30 per cent. of doctors there still provide a service under the Northern Doctors Urgent Care arrangement during the week—and they are local doctors. Various arrangements are being put in place, including one GP on duty after midnight at either Alnwick or Berwick, and a driver is supposedly available overnight. I take note of the right hon. Gentleman's comments on that. The majority of local doctors do not provide weekend services and that is when agency doctors are mainly used. A large team is on call, which should allow for flexibility in travel arrangements. The aim is to work to achieve the targets of responding to all urgent calls within two hours and to non-urgent ones within six hours. Again, I note the right hon. Gentleman's comments about the time scale of some of the calls that he has drawn to the attention of the House.
	As a result of examining the issue, and mindful of the fact that the trust has had a few months to see the system operate, I am pleased to say that the two trusts—I agree with the right hon. Gentleman about the confusion of the names—jointly agreed to review urgent care systems across the county, and it is expected that the review will be concluded by the end of February. I trust that it will be concluded at that time, as I appreciate that many of the issues raised by the right hon. Gentleman are of significant concern to his constituents—and rightly so. I am aware of worries about journeys to Wansbeck. Sometimes, such journeys are necessary to provide the best possible clinical care, which can often be received only at a general hospital. I am sure that the right hon. Gentleman would not argue with that.
	As to coverage, what we aspire to and what is being delivered in other areas is that the service provided should meet the national quality requirements provided by the primary care trust. The PCT must performance-manage the provider to ensure that that happens. Where the provider fails to meet the requirements, action has to be taken to deal with it. Clear times should be specified within which patients should receive an initial clinical assessment and receive clinical treatment, which may vary, depending on the seriousness of the condition or disease. Providers must ensure that patients are treated by the clinician best equipped to meet their needs in the appropriate location. Where a face-to-face consultation is necessary, it must take place within clearly defined time scales.
	On some occasions, patients may need to travel. They may need to attend an accident and emergency, hospital or clinic-based outpatients' appointment, for example, and the PCT has a duty to recognise that the distance should not be unrealistic, though it should not preclude patients who urgently need a face-to-face consultation being seen within the specified time frame.
	As I said, I am pleased that the strategic health authority announced today that it would undertake a review, and I trust that it will be conducted speedily. I will additionally ask the Recovery and Support Unit in the Department to ensure that it supports colleagues at the SHA in carrying out its review of services. The right hon. Gentleman might like to note that in February and March we are also bringing together out-of-hours providers and PCTs in a series of workshops across the country, to focus on ensuring the quality of out-of-hours services and how providers and commissioners can work together on managing performance.
	In that connection, I promised that I would turn to the question of how the service is organised elsewhere—in central Cheshire, for example. It is across the other side of the country, but not a million miles from where the right hon. Gentleman is based. There, all 30 practices opted out on 1 April 2004. The PCTs established an all-encompassing out-of-hours service covering an area formerly provided for by five co-operatives. It integrates GPs, nurses and paramedics in a way that has not been widely remarked on. Triage nurses advise patients or refer them to treatment centres in Crewe or Northwich, and home visits are made by paramedics. Between 50 per cent. and 60 per cent. of the area's 140 GPs have agreed to do shifts for the PCT, and salaried GPs are also employed.
	I could give other examples from around the country. People are configuring services to reflect how they can best be delivered. Clearly, issues arise in respect of an area's pattern of towns and settlements, as well as its geography and provision of GPs, hospitals and other services. However, a number of areas have taken a creative approach to producing a better and more seamless service, with a much wider skills mix among the people who provide the care. There is a much better distribution than was the case historically of the way in which patients are seen by GPs with the relevant skills, at the relevant time and in the most relevant place.

Alan Beith: May I observe that, under the old system, we were lucky? We had a well integrated GP and hospital service. The GPs provided the hospital night service and used that as the base for attending house calls. Will the Minister clarify how the Secretary of State's promise that there would be Saturday morning surgeries will be met? Patients who are not emergencies but whose needs are pressing must be able to know that they can see a doctor on a Saturday morning.

Melanie Johnson: People can see a doctor on a Saturday morning, as I am sure the right hon. Gentleman appreciates. The question of whether they can see their own doctor is a separate matter. Whatever his criticisms of the provision in his area, I understand that people in Northumberland are able to see a GP on a Saturday morning, and that there is no problem about access normally. I do not think that I can say anything more about that.
	I shall also ensure that the SHA looks at the regular performance reviews of the interaction between the commissioner and the provider, and that it will consider matters such as performance, capacity, contingency arrangements and the suitability of commissioned out-of-hours service. Prompt action should be taken to resolve any problems that arise.
	I appreciate that this is a serious matter, and that the right hon. Member for Berwick-upon-Tweed has raised issues that we must be sure that we can deal with. The SHA and the PCT must also ensure that they can deal with these matters. However, I assure the right hon. Gentleman that we take his comments seriously, and that the local trust will want to address the matters that he has raised.
	The PCT is in the lead when it comes to service provision, and the right hon. Gentleman and I will agree that local decisions are best made locally. Appropriate investment has been made to render that possible, and I am sure that the relevant local bodies will be keen to ensure that health provision is up to the standard that we all expect in this century. We want out-of-hours care to be targeted as much as possible in the appropriate way, and to be available to people as necessary, regardless of the hour of day or night.
	Question put and agreed to.
	Adjourned accordingly at twenty eight minutes past Seven o'clock.